Screening for clinical Percentage of patients ages 18 years CMS X depression and and older screened for clinical care depression using an age-appropriate standardized tool AND follow-up plan documented. Controlling blood Percentage of members 18-85 years of NCQA/HEDIS X pressure age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90) for members 18-59 years of age and 60-85 years of age with diagnosis of diabetes or (150/90) for members 60-85 without a diagnosis of diabetes during the measurement year. Part D medication Percent of plan members with a CMS X adherence for diabetes prescription for diabetes medication medications who fill their prescription often enough to cover 80% or more of the time they are supposed to be taking the medication. Initiation and The percentage of adolescent and adult NCQA/HEDIS X engagement of alcohol members with a new episode of alcohol and other drug or other drug (AOD) dependence who dependence treatment received the following: Initiation of AOD Treatment. The 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. Engagement of AOD Treatment. The 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. Encounter data Encounter data submitted accurately CMS/State X (for DY 3 only) and completely in compliance with defined Contract requirements. process measure American Recovery and Reinvestment Act of 2009
Screening for clinical depression and care Percentage of patients ages 18 years and older screened for clinical depression using an age-appropriate standardized tool AND follow-up plan documented. CMS X Controlling blood pressure Percentage of members 18-85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90) for members 18-59 years of age and 60-85 years of age with diagnosis of diabetes or (150/90) for members 60-85 without a diagnosis of diabetes during the measurement year. NCQA/HEDIS X Part D medication adherence for diabetes medications Percent of plan members with a prescription for diabetes medication who fill their prescription often enough to cover 80% or more of the time they are supposed to be taking the medication. CMS X Initiation and engagement of alcohol and other drug dependence treatment The percentage of adolescent and adult members with a new episode of alcohol or other drug (AOD) dependence who received the following: Initiation of AOD Treatment. The 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. Engagement of AOD Treatment. The 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. NCQA/HEDIS X Encounter data (for DY 3 only) Encounter data submitted accurately and completely in compliance with Contract requirements. CMS/State defined process measure X American Recovery and Reinvestment Act of 2009