Ambulatory Care: Clinic

To assess the use of and persistence to ACE inhibitors or Angiotensin receptor blockers (ARB) among members with CAD or other atherosclerotic vascular disease (i.e., peripheral arterial disease, atherosclerotic aortic disease and carotid artery disease) who are at high risk for coronary events during a one year period. High-risk comorbidities are defined as heart failure, hypertension, diabetes, or chronic kidney disease (excluding stage V and patients on dialysis).

The measure addresses adherence to three types of chronic medications: statins, levothyroxine, and angiotensin converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs). The measure is divided into three submeasures:

Measure A: The percentage of eligible individuals who had at least two prescriptions for statins and who have a Proportion of Days Covered (PDC) of at least 0.8 during the measurement period (12 consecutive months).

Documents whether provider has adopted a qualified e-Prescribing system and the extent of use in the ambulatory setting.

Percentage of patients who were evaluated during at least one office visit for the frequency (numeric) of daytime and nocturnal asthma symptoms

Percentage of patients who have a claim indicating beta blocker therapy or who received an ambulatory prescription for beta-blockers rendered within 7 days after discharge.

Medication Possession Ratio (MPR) for ACEI/ARB therapy for individuals with Chronic Kidney Disease (CKD) and/or diabetes mellitus and hypertension.

Percentage of patients with COPD with oxygen saturation assessed at least annually

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12 month period who have a LDL-C result <100 mg/dL OR patients who have a LDL-C result >=100 mg/dL and have a documented plan of care to achieve LDL-C <100mg/dL, including at a minimum the prescription of a statin

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12 month period for whom there is documented results of an evaluation of level of activity AND an evaluation of presence or absence of anginal symptoms in the medical record

Percentage of patients 40 years and older with COPD exacerbations that are receiving a long acting bronchodilator