Outpatient Services

To ensure that members with chronic kidney disease are monitored for PTH levels at least once annually.

Risk-Standardized rate of acute, unplanned hospital admissions among Medicare Fee-for-Service (FFS) patients aged 65 years and older with multiple chronic conditions (MCCs).

Percentage of patients aged 18 years through 80 years with AJCC Stage III colon cancer who are referred for adjuvant chemotherapy, prescribed adjuvant chemotherapy or have previously received adjuvant chemotherapy within the 12-month reporting period

Percentage of patients aged 18 years and older receiving a surveillance colonoscopy, with a history of a prior adenomatous polyp(s) in previous colonoscopy findings, which had an interval of 3 or more years since their last colonoscopy

Percentage of colon and rectum cancer resection pathology reports that include the pT category (primary tumor), the pN category (regional lymph nodes) and the histologic grade

The percentage of patients 50–75 years of age who had appropriate screening for colorectal cancer.

Percentage of adults 50 years and older treated for a fracture with documentation of communication, between the physician treating the fracture and the physician or other clinician managing the patient’s on-going care, that a fracture occurred and that the patient was or should be considered for osteoporosis treatment or testing. This measure is reported by the physician who treats the fracture and who therefore is held accountable for the communication.

Percentage of patients aged 18 years and older with a diagnosis of community-acquired bacterial pneumonia (CAP) with an appropriate empiric antibiotic prescribed

Measure title continued: Composite weighted average for 3 CT Exam Types: Overall Percent of CT exams for which Dose Length Product is at or below the size-specific diagnostic reference level (for CT Abdomen-pelvis with contrast/single phase scan, CT Chest without contrast/single phase scan and CT Head/Brain without contrast/single phase scan)

The percentage of patients 18–75 years of age with diabetes (type 1 and type 2) who had each of the following:
- Hemoglobin A1c (HbA1c) testing (NQF#0057)
- HbA1c poor control (>9.0%) (NQF#0059)
- HbA1c control (<8.0%) (NQF#0575)
- HbA1c control (<7.0%) for a selected population*
- Eye exam (retinal) performed (NQF#0055)
- LDL-C screening (NQF#0063)
- LDL-C control (<100 mg/dL) (NQF#0064)
- Medical attention for nephropathy (NQF#0062)
- BP control (<140/90 mm Hg) (NQF#0061)
- Smoking status and cessation advice or treatment