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Highest Opportunity for Improvement

Pharmacotherapy Management of COPD Exacerbation

  • This measure assesses the percentage of COPD exacerbations for patients 40 years of age and older who had an acute inpatient discharge or ED visit on or between January 1-November 30 of the measurement year and who were dispensed appropriate medications. Two rates are reported:
    1. Dispensed a systemic corticosteroid (or there was evidence of an active prescription) within 14 days of the event.
    2. Dispensed a bronchodilator (or there was evidence of an active prescription) within 30 days of the event.

    CBE ID
    2856

Plan All-Cause Readmissions (PCR)

  • For patients 18 years of age and older, the number of acute inpatient stays during the measurement year that were followed by an unplanned acute readmission for any diagnosis within 30 days and the predicted probability of an acute readmission. Data are reported in the following categories:

    1. Count of Index Hospital Stays* (denominator)
    2. Count of 30-Day Readmissions (numerator)
    3. Average Adjusted Probability of Readmission

    *An acute inpatient stay with a discharge during the first 11 months of the measurement year (e.g., on or between January 1 and December 1).

    CBE ID
    1768

PointRight ® Pro 30™

  • PointRight OnPoint-30 is an all-cause, risk adjusted rehospitalization measure. It provides the rate at which all patients (regardless of payer status or diagnosis) who enter skilled nursing facilities (SNFs) from acute hospitals and are subsequently rehospitalized during their SNF stay, within 30 days from their admission to the SNF.

    CBE ID
    2375

Potentially Harmful Drug-Disease Interactions in the Elderly

  • The percentage of patients 65 years of age and older who have evidence of an underlying disease, condition or health concern and who are dispensed an ambulatory prescription for a potentially harmful medication, concurrent with or after the diagnosis. Three rates are reported for this measure:
    -Rate 1: The percentage of those with a history of falls that received a potentially harmful medication
    -Rate 2: The percentage of those with dementia that received a potentially harmful medication

    CBE ID
    2993

Prescription of HIV Antiretroviral Therapy

  • Percentage of patients, regardless of age, with a diagnosis of HIV prescribed antiretroviral therapy for the treatment of HIV infection during 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
    2083

Prescription or administration of pharmacotherapy to treat opioid use disorder (OUD)

  • This measure reports the percentage of a provider’s patients who were Medicaid beneficiaries ages 18 to 64 with an OUD diagnosis who filled a prescription for, or were administered or ordered, a FDA-approved medication to treat OUD within 30 days of the first attributable OUD treatment encounter with that provider.

    CBE ID
    3589

Preventive Care and Screening: Influenza Immunization

  • Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

    CBE ID
    0041