Electronic administrative data/claims

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 and is using health information technology. To qualify, the provider must have adopted and be using a certified/qualified electronic health record (EHR).

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

Percentage of acute myocardial infarction (AMI) patients who expired during hospital stay.

All non-maternal discharges of age 18 years and older with ICD-9-CM principal diagnosis code for angina.

Number of procedures for which the patient was discharged from the facility on Aspirin, enteric coated aspirin, or ADP Inhibitors/ Number of Isolated CABG procedures excluding those that resulted in in-hospital mortalities based on the variables Mortality Discharge Status, Mortality Date, and Discharge Date

Percent of adult patients undergoing cervical spine radiography or CT imaging for trauma who have a documented evidence-based indication prior to imaging (Canadian C-Spine Rule or the NEXUS Low-Risk Criteria).

Percentage of patients aged 18 years and older with the diagnosis of community-acquired bacterial pneumonia with mental status assessed

Percentage of patients aged 18 years and older with the diagnosis of community-acquired bacterial pneumonia with mental status assessed