Disease Management Performance Measures

Condition-Based Measures

Asthma

·    Use of Appropriate Medications for People with Asthma: Percentage of asthma eligible patients who appropriately prescribed medication during the measurement year

Chronic Obstructive Pulmonary Disease (COPD)

·    Preventive Measures Only

·    Percentage of COPD eligible patients who were assessed for: Tobacco Use, Assistance with Tobacco Cessation, Influenza Vaccination, and Pneumococcal Vaccination

Diabetes

·    Comprehensive Diabetes Care: Percentage of diabetes eligible patients receiving Comprehensive Diabetes Care*

  *Comprehensive diabetes care encompasses the following assessments:

·    Hemoglobin A1c
(HbA1c ) testing

·     HbA1c poor control (>9.0%)

·     HbA1c control (<8.0%)

·     HbA1c control (<7.0%)

·     Eye exam (retinal) performed

·     LDL-C screening performed

·     LDL-C control (<100mg/dL)

·     Medical attention for nephropathy

 

Congestive Heart Failure (CHF)

·    Preventive Measures Only

·    Percentage of Heart Failure eligible patients who were assessed for: Tobacco Use, Assistance with Tobacco Cessation, Influenza Vaccination, and Pneumococcal Vaccination

Ischemic Vascular Disease (IVD)

 

 

·    Cholesterol Management for People with Ischemic Vascular Disease: Percentage of IVD eligible patients who had a LDL-C screening and maintained their LDL-C level <100mg/dL during the measurement year

·    Persistence of Beta Blocker Treatment after a Heart Attack: Percentage of AMI eligible patients who received persistent beta-blocker treatment for at least six months after discharge

·    Aspirin or other Antithrombotic Use by People with Ischemic Vascular Disease: Percentage of IVD eligible patients who were recommended daily aspirin use during the 12 month measurement period

Preventive Measures

Tobacco Use

·    Assessing Tobacco Use: Percentage of the eligible population who were asked about their use of tobacco products

·    Assistance with Tobacco Cessation: Percentage of the eligible population who received the following components of this measure.

·          Advising to Quit: Percentage of members 18 years of age and older who were current smokers, who were seen by a practitioner or qualified DM representative during the measurement year and who received advice on tobacco use cessation

·          Discussing Cessation Strategies: Percentage of members 18 years of age and older who were current tobacco users, for whom cessation methods or strategies were recommended or discussed

Influenza Vaccination

·    Influenza Vaccination: Percentage of the eligible population who have received an influenza vaccine

Pneumococcal Vaccination

·    Pneumococcal Vaccination: Percentage of the eligible population who have received an pneumococcal vaccine