the positive screen Adult Body Mass Index A QOC Annual BMI value Star service auto fill Bi-Annual % of members 18-74 yrs (those Assessment (BMI) – with at least one outpatient visit adults [ABA] during the measurement year) who CMS criterion had their BMI documented during the measurement year or the year prior to the measurement year Weight Assessment C QOC Semi-annual % of members ages 3-17 who had BMI value Star service auto fill Quarterly Children – (BMI) visit and had 9 BMI documented during the measurement year or the year prior to measurement year (NOTE: actual BMI will be graphed over time) Diabetes screening for A QOC Annual % of adults ages 40-70 who are HbA1c or Star service auto fill Annual adults that are overweight or obese that had a glucose overweight or obese glucose test or HbA1c value Diabetes screening for B QOC Semi-annual % of members ages 18 & > having a HbA1c or Star service auto fill Quarterly people who are on glucose test or an Hba1c during the glucose atypical anti-psychotics measurement year value (HbA1C) Physical examination B QOC Annual % of members w physical exam Date of Star service auto fill Admission within 1 month of w/in 1 month of HH opt-in exam + 1 month admission to HH or transfer of records current within the last 12 months Serum lipid profile for A QOC Annual % of members ages 18-74 who had Actual Star service auto fill Annual adults with SMI who serum lipid profile done value are on atypical Screening for cervical A QOC Annual % of women ages 21-64 meeting +/- MCO Every 3 yrs cancer HEDIS the criteria
the positive screen Adult Body Mass Index Assessment (BMI) – adults [ABA] CMS criterion A QOC Annual % of members 18-74 yrs (those with at least one outpatient visit during the measurement year) who had their BMI documented during the measurement year or the year prior to the measurement year BMI value Star service auto fill Bi-Annual Weight Assessment Children – (BMI) C QOC Semi-annual % of members ages 3-17 who had visit and had 9 BMI documented during the measurement year or the year prior to measurement year (NOTE: actual BMI will be graphed over time) BMI value Star service auto fill Quarterly Diabetes screening for adults that are overweight or obese A QOC Annual % of adults ages 40-70 who are overweight or obese that had a glucose test or HbA1c HbA1c or glucose value Star service auto fill Annual Diabetes screening for people who are on atypical anti-psychotics (HbA1C) B QOC Semi-annual % of members ages 18 & > having a glucose test or an Hba1c during the measurement year HbA1c or glucose value Star service auto fill Quarterly Physical examination within 1 month of admission to HH or transfer of records current within the last 12 months B QOC Annual % of members w physical exam w/in 1 month of HH opt-in Date of exam Star service auto fill Admission + 1 month Serum lipid profile for adults with SMI who are on atypical A QOC Annual % of members ages 18-74 who had serum lipid profile done Actual value Star service auto fill Annual Screening for cervical cancer A QOC HEDIS Annual % of women ages 21-64 meeting the criteria +/- MCO Every 3 yrs
Provider%20Pol%20Manual%20MP%20SW%2011_30_17.docx