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Claims Data

Valid for Measure Submission

Methotrexate: CBC within 12 weeks

  • This measure identifies adult patients with rheumatoid arthritis who were prescribed at least a 6-month supply of methotrexate during the measurement year and received a CBC test within 120 days (3 months + 1 month grace period) following the earliest observed methotrexate prescription claim

    CBE ID
    0598

Methotrexate: Creatinine within 12 weeks

  • This measure identifies adult patients with rheumatoid arthritis who were prescribed at least a 6-month supply of methotrexate during the measurement year and received a serum creatinine test in the 120 days (3 months + 1 month grace period) after the earliest observed methotrexate prescription claim.

    CBE ID
    0599

Methotrexate: LFT within 12 weeks

  • This measure identifies adult patients with rheumatoid arthritis who were prescribed at least a 6-month supply of methotrexate during the measurement year and received a liver function test (LFT) in the 120 days (3 months + 1 month grace period) following the earliest observed methotrexate prescription claim.

    CBE ID
    0597

MI - Use of Beta Blocker Therapy

  • The percentage of patients aged 18 years and older diagnosed with myocardial infarction (MI) who are taking a beta blocker

    CBE ID
    0613e

Minimizing Institutional Length of Stay

  • The proportion of admissions to an institutional facility (e.g., nursing facility, intermediate care facility for individuals with intellectual disabilities [ICF/IID]) for managed long-term services and support (MLTSS) plan enrollees that result in successful discharge to the community (community residence for 60 or more days) within 100 days of admission. This measure is reported as an observed rate and a risk-adjusted rate.

    CBE ID
    3457

Minimum Delivered Peritoneal Dialysis Dose

  • Percentage of patient months for adult and pediatric patients whose delivered peritoneal dialysis dose was a weekly Kt/Vurea (dialytic + residual) >= 1.7 (adult, >=18) or >= 1.8 (pediatric, <18).

    CBE ID
    2704

Minimum spKt/V for Pediatric Hemodialysis Patients

  • Percentage of patient months for all pediatric (<18 years old) in-center hemodialysis patients in which the delivered dose of hemodialysis (calculated from the last measurement of the month using the UKM or Daugirdas II formula) was spKt/V >= 1.2.

    CBE ID
    1423

Monitoring hemoglobin levels below target minimum

  • Percentage of all adult (>=18 years old) hemodialysis patients, peritoneal dialysis, and home hemodialysis patients with ESRD >=3 months and who had Hb values reported for at least 2 of the 3 study months, who have a mean Hb <10.0 g/dL for a 3 month study period, irrespective of ESA use.

    CBE ID
    0370

Monthly Hemoglobin Measurement for Pediatric Patients

  • Percentage of patient months of pediatric (< 18 years old) in-center hemodialysis, home hemodialysis, and peritoneal dialysis patients who have monthly measures for hemoglobin during the reporting period.

    CBE ID
    1424