NQMC Update Service: September 9, 2013 ► National Committee for Quality Assurance

NQMC Update Service: September 9, 2013

September 9, 2013

NQMC Update Service: September 9, 2013

Agency for Healthcare Research and Quality (AHRQ) sent this bulletin at 09/09/2013 12:00 PM EDT

September 9, 2013

New This Week

Measure Summaries

National Committee for Quality Assurance

• Adolescent well-care visits: percentage of enrolled members 12 to 21 years of age who had at least one comprehensive well-care visit with a PCP or an OB/GYN practitioner during the measurement year. This updates a previously published measure summary.

• Adults' access to preventive/ambulatory health services: percentage of members 20 years and older who had an ambulatory or preventive care visit. This updates a previously published measure summary.

• Ambulatory care: summary of utilization of ambulatory care in the following categories: outpatient visits and ED visits. This updates a previously published measure summary.

• Annual dental visit: percentage of members 2 to 21 years of age who had at least one dental visit during the measurement year. This updates a previously published measure summary.

• Antibiotic utilization: summary of outpatient utilization of antibiotic prescriptions during the measurement year, stratified by age and gender. This updates a previously published measure summary.

• Call answer timeliness: percentage of calls received by the organization's Member Services call centers (during operating hours) during the measurement year that were answered by a live voice within 30 seconds. This updates a previously published measure summary.

• Children and adolescents' access to primary care practitioners (PCP): percentage of members 12 months to 19 years of age who had a visit with a PCP. This updates a previously published measure summary.

• Engagement of alcohol and other drug (AOD) treatment: percentage of members who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit. This updates a previously published measure summary.

• Frequency of ongoing prenatal care: percentage of Medicaid deliveries between November 6 of the year prior to the measurement year and November 5 of the measurement year that received less than 21%, 21% to 40%, 41% to 60%, 61% to 80%, or greater than or equal to 81% of the expected number of prenatal care visits. This updates a previously published measure summary.

• Frequency of selected procedures: summary of utilization of fourteen frequently performed procedures. This updates a previously published measure summary.

• Identification of alcohol and other drug services: summary of the number and percentage of members with an alcohol and other drug (AOD) claim who received the following chemical dependency services during the measurement year: any service, inpatient, intensive outpatient or partial hospitalization, and outpatient or ED. This updates a previously published measure summary.

• Initiation of alcohol and other drug (AOD) treatment: percentage of members who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter, or partial hospitalization within 14 days of the diagnosis. This updates a previously published measure summary.

• Inpatient utilization—general hospital/acute care: summary of utilization of acute inpatient care and services in the following categories: total inpatient, medicine, surgery, and maternity. This updates a previously published measure summary.

• Mental health utilization: number and percentage of members receiving the following mental health services during the measurement year: any service, inpatient, intensive outpatient or partial hospitalization, and outpatient or ED. This updates a previously published measure summary.

• Plan all-cause readmissions: the number of acute inpatient stays during the measurement year that were followed by an acute readmission for any diagnosis within 30 days and the predicted probability of an acute readmission, for members 18 years of age and older. This updates a previously published measure summary.

• Postpartum care: percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery. This updates a previously published measure summary.

• Timeliness of prenatal care: percentage of deliveries that received a prenatal care visit as a member of the organization in the first trimester or within 42 days of enrollment in the organization. This updates a previously published measure summary.

• Well-child visits in the first 15 months of life: percentage of members who turned 15 months old during the measurement year and who had the following number of well-child visits with a PCP during their first 15 months of life: zero, one, two, three, four, five, six or more. This updates a previously published measure summary.

• Well-child visits in the third, fourth, fifth and sixth years of life: percentage of members 3 to 6 years of age as who had one or more well-child visits with a PCP during the measurement year. This updates a previously published measure summary.