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No risk adjustment or risk stratification

Follow-Up Care for Children Prescribed ADHD Medication (ADD)

  • Percentage of children newly prescribed attention-deficit/hyperactivity disorder (ADHD) medication who had at least three follow-up care visits within a 10-month period, one of which is within 30 days of when the first ADHD medication was dispensed.
    An Initiation Phase Rate and Continuation and Maintenance Phase Rate are reported.

    CBE ID
    0108

Frequency of Ongoing Prenatal Care (FPC)

  • The percentage of Medicaid deliveries that had the following number of expected prenatal visits:

    • less than 21 percent of expected visits.

    • 21 percent–40 percent of expected visits.

    • 41 percent–60 percent of expected visits.

    • 61 percent–80 percent of expected visits.

    • greater than or equal to 81 percent of expected visits.

    CBE ID
    1391

Functional Outcome Assessment

  • Percentage of visits for patients aged 18 years and older with documentation of a current functional outcome assessment using a standardized functional outcome assessment tool on the date of the encounter AND documentation of a care plan based on identified functional outcome deficiencies on the date of the identified deficiencies

    CBE ID
    2624

Gap in HIV medical visits

  • Percentage of patients, regardless of age, with a diagnosis of HIV who did not have a medical visit in the last 6 months of the measurement year

    A medical visit is any visit in an outpatient/ambulatory care setting with a nurse practitioner, physician, and/or a physician assistant who provides comprehensive HIV care.

    CBE ID
    2080

Gastroenteritis Admission Rate (PDI 16)

  • Admissions for a principal diagnosis of gastroenteritis, or for a principal diagnosis of dehydration with a secondary diagnosis of gastroenteritis per 100,000 population, ages 3 months to 17 years. Excludes cases transferred from another facility, cases with gastrointestinal abnormalities or bacterial gastroenteritis, and obstetric admissions.

    CBE ID
    0727

Gastrointestinal Hemorrhage Mortality Rate (IQI #18)

  • In-hospital deaths per 1,000 hospital discharges with gastrointestinal hemorrhage as a principal diagnosis for patients age 18 years and older. Excludes obstetric discharges and transfers to another hospital.

    [NOTE: The software provides the rate per hospital discharge. However, common practice reports the measure as per 1,000 discharges. The user must multiply the rate obtained from the software by 1,000 to report in-hospital deaths per 1,000 hospital discharges.]

    CBE ID
    2065