Clinical Measures for Future Evaluation

Clinical Measures for Future Evaluation

Measures

Drug-Drug Interactions

Cholesterol Management in Coronary Artery Disease

Completion Rate for CMR

Antipsychotic Use in Persons with Dementia

Adherence to Antipsychotic Medication for Individuals with Schizophrenia (SAA)

Annual Monitoring for Patients on persistent Medications (MPM)

Potentially Harmful Drug-Disease Interactions in the Elderly (DDE)

New Measurements Scoring Methodology

Measures	Allocation for 2015-2016 Program
Proportion of Days Covered - 3 separate measures (HTN, Diabetes, and Statin)	3x1.5=4.5
Asthma Suboptimal Control (NEW)	1
Absence of Controller Therapy	1.5
Statin Use in Diabetes (NEW)	1
Use of High-Risk Medications in the Elderly	1
Generic Rate	1
Total	10

• Payment Threshold
  • Meet or Exceed Target: Full %
  • Meet or Exceed Benchmark: 1/2%
  • Fail to Meet Benchmark: 0%
• Store will get full point only if exceeding the benchmark score
• Total possible points: 10 = 100% (each point is 10%)
• P4P dollar/Total volume = P4P value in dollar/volume
• Store P4P payout: Performance% x (P4P value)

Measurement Title	Measurement Description
Proportion of Days Covered (PDC)	The percentage of patients 18 years and older who met the Proportion of Days Covered (PDC) threshold of 80 percent during the measurement period. Report a rate for each of the following: Beta-blocker (BB) Renin Angiotensin System (RAS) Antagonists Statin Biguanide Sulfonylurea Thiazolidinedione DiPeptidyl Peptidase (DPP)-IV Inhibitor Diabetes Roll-up Anti-retroviral (this measure has a threshold of 90% for at least 2 medications)
Diabetes: Appropriate Treatment of Hypertension	The percentage of patients who were dispensed a medication for diabetes that were also dispensed a direct renin inhibitor medication, a angiotensin converting enzyme inhibitor (ACE), or angiotensin II receptor blockers (ARB).
Medication Therapy for Persons with Asthma	The percentage of patients with asthma who were dispensed more than 3 canisters of a short-acting beta2 agonist inhaler over a 90-day period and who did not receive controller therapy during the same 90-day period. Two rates are reported. Suboptimal Control. The percentage of patients with persistent asthma who were dispensed more than 3 canisters of a short-acting beta2 agonist inhaler during the same 90-day period. Absence of Controller Therapy. The percentage of patients with asthma during the measurement period who were dispensed more than 3 canisters of short acting beta2 agonist inhalers over a 90-day period and who did not receive controller therapy during the same 90-day period.
Use of High-Risk Medications in the Elderly (HRM)	The percentage of patients 65 years of age and older who received two or more prescription fills for a high-risk medication during the measurement period.
Statin Use in Persons with Diabetes	The percentage of patients ages 40-75 years who were dispensed a medication for diabetes that receive a statin medication.