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Valid for Measure Submission

Adherence to Antipsychotic Medications for Individuals with Schizophrenia

  • Percentage of individuals at least 18 years of age as of the beginning of the measurement period with schizophrenia or schizoaffective disorder who had at least two prescription drug claims for antipsychotic medications and had a Proportion of Days Covered (PDC) of at least 0.8 for antipsychotic medications during the measurement period (12 consecutive months).

    CBE ID
    1879

Adherence to Chronic Medications

  • 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).

    CBE ID
    0542e

Adherence to Mood Stabilizers for Individuals with Bipolar I Disorder

  • Percentage of individuals at least 18 years of age as of the beginning of the measurement period with bipolar I disorder who had at least two prescription drug claims for mood stabilizer medications and had a Proportion of Days Covered (PDC) of at least 0.8 for mood stabilizer medications during the measurement period (12 consecutive months).

    CBE ID
    1880

Adherence to Oral Diabetes Agents for Individuals with Diabetes Mellitus

  • The measure addresses adherence to oral diabetes agents (ODA). The measure is reported as the percentage of eligible individuals with diabetes mellitus who had at least two prescriptions for a single oral diabetes agent or at least two prescriptions for multiple agents within a diabetes drug class and who have a Proportion of Days Covered (PDC) of at least 0.8 for at least one diabetes drug class during the measurement period (12 consecutive months)

    CBE ID
    2468

Adherence to Statin Therapy for Individuals with Cardiovascular Disease

  • The percentage of individuals with cardiovascular disease (CVD), including coronary artery disease, cerebrovascular disease, and peripheral artery disease presumed to be of atherosclerotic origin, who are prescribed statin therapy that had a Proportion of Days Covered (PDC) for statin medications of at least 0.8 during the measurement period (12 consecutive months).

    CBE ID
    0543

ADHERENCE TO STATINS

  • To ensure that members who are taking statins to treat hyperlipidemia filled sufficient medication to have at least 80% coverage during the measurement year.

    CBE ID
    0569

Adherence to Statins for Individuals with Diabetes Mellitus

  • The measure addresses adherence to statins. The measure is reported as the percentage of eligible individuals with diabetes mellitus 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).

    CBE ID
    0545

Adjuvant chemotherapy is recommended, or administered within 4 months (120 days) of diagnosis for patients under the age of 80 with AJCC Stage III (lymph node positive) colon cancer

  • Percentage of patients, age = 18 and < 80 at diagnosis, who have their first diagnosis of cancer (epithelial malignancy) that is lymph node positive and at AJCC stage III, whose primary tumor is of the colon and chemotherapy was recommended or administered within 4 months (120 days) of diagnosis

    CBE ID
    0223

Adjuvant hormonal therapy is recommended or administered within 1 year (365 days) of diagnosis for women with AJCC T1cN0M0 or Stage IB – Stage III hormone receptor positive breast cancer

  • Percentage of female patients, age = 18 at diagnosis, who have their first diagnosis of cancer (epithelial malignancy), at AJCC T1cN0M0 or stage IB to IIIC, whose primary tumor is of the breast, and is progesterone or estrogen receptor positive with adjuvant hormonal therapy (recommended or administered) within 1 year (365 days) of diagnosis

    CBE ID
    0220