NQMC Update Service: April 21, 2014 ▲ National Committee for Quality Assurance

NQMC Update Service: April 21, 2014

April 21, 2014

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.

• Ambulatory care: summary of utilization of ambulatory care in the following categories: outpatient visits and ED visits. 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.

• Asthma: the relative resource use by members with persistent asthma during the measurement year. This updates a previously published measure summary.

• Cardiovascular conditions: the relative resource use by members with cardiovascular conditions during the measurement year. This updates a previously published measure summary.

• Chronic obstructive pulmonary disease (COPD): the relative resource use by members with COPD during the measurement year. This updates a previously published measure summary.

• Diabetes: the relative resource use by members with diabetes during the measurement year. 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.

• Hypertension: the relative resource use by members with hypertension during the measurement year. 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.

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

• 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 who had one or more well-child visits with a PCP during the measurement year. This updates a previously published measure summary.