Setting of Care: Reporting Period: Outpatient Annual; April Experience Period: Baseline Period: Calendar Year CY 2017 01 Inpatient Hospital Claim Type(s): – 09 Supplies, DME 16 Lab – – 02 Long Term Care – Podiatry Prosthetic and Orthotics 10 17 – – 03 Outpatient Hospital – 11 11 Dental 18 Independent Clinic – – 04 Physician – 12 Pharmacy 19 Psychologists – – Chiropractor 05 – 13 EPDST/Healthstart 21 Optometrists – – 06 Home Health – 14 Institutional Crossover 22 Mid Level Practitioner – – 07 Transportation – 15 Professional Crossover 23 Hearing Aid – – 08 Vision – Yes No No Continuous Eligibility Period: Risk Adjustment: Sampling: Continuous Eligibility/ Risk Adjustment/ Sampling Methodology: The patient is to be continuously enrolled for the measurement year with no more than a 45 day gap during the year. DSRIP Incentive Impact Project Title: Project Code: Payment Method: NA NA NA Universal Measure: Universal Code: Payment Method: NA NA NA Stage 1 Measure: Code: Payment Method: Yes NA P4R Measure: DSRIP #: 107 Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics Measure Description: The percentage of members 1–17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychosocial care as first line treatment. Report 3 age stratifications and a total rate: 1 5 years – 6 11 years – 12 - 17 years Total Data Source: NQF #: MMIS/PHARM 2801 Measure Steward: Measure Steward Version: NCQA 2017 Measure Calculation Description Numerator: Documentation of psychosocial care (Appendix A S1-11) in the 121-day period from 90 days prior to the Index Prescription Start Date (IPSD) through 30 days after the IPSD. Exclusion(s):
Setting of Care: Outpatient Reporting Period: Annual; April Experience Period: Calendar Year Baseline Period: CY 2017 Claim Type(s): 11 01 – Inpatient Hospital 02 – Long Term Care 03 – Outpatient Hospital 04 – Physician 05 – Chiropractor 06 – Home Health 07 – Transportation 08 – Vision 09 – Supplies, DME 10 – Podiatry 11 – Dental 12 – Pharmacy 13 – EPDST/Healthstart 14 – Institutional Crossover 15 – Professional Crossover 16 – Lab 17 – Prosthetic and Orthotics 18 – Independent Clinic 19 – Psychologists 21 – Optometrists 22 – Mid Level Practitioner 23 – Hearing Aid Continuous Eligibility Period: Yes Risk Adjustment: No Sampling: No Continuous Eligibility/ Risk Adjustment/ Sampling Methodology: The patient is to be continuously enrolled for the measurement year with no more than a 45 day gap during the year. DSRIP Incentive Impact Project Title: NA Project Code: NA Payment Method: NA Universal Measure: NA Universal Code: NA Payment Method: NA Stage 1 Measure: Yes Code: NA Payment Method: P4R Measure: Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics DSRIP #: 107 Measure Description: The percentage of members 1–17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychosocial care as first line treatment. Report 3 age stratifications and a total rate: 1 – 5 years 6 – 11 years 12 - 17 years Total Data Source: MMIS/PHARM NQF #: 2801 Measure Steward: NCQA Measure Steward Version: 2017 Measure Calculation Description Numerator: Documentation of psychosocial care (Appendix A S1-11) in the 121-day period from 90 days prior to the Index Prescription Start Date (IPSD) through 30 days after the IPSD. Exclusion(s):
Addendum%20to%20Databook%20-%20DY7%20-%20DY8%20Stage%201%20System%20Transformation%20Measure%20Update.docx