|
Measure ID |
Measure Title |
Measure Description |
Denominator |
Numerator |
Denominator Exclusions |
Denominator Exceptions |
Numerator Exclusions |
Data Source Used for the Measure
|
Does this measure belong to another QCDR? If so, which
one? |
NQF Number
(if applicable) |
NQS Domain |
NQS Domain Rationale |
Outcome or High Priority?
|
High Priority Type |
Measure Type
|
Inverse Measure
|
Proportional Measure
|
Continuous Variable Measure
|
Ratio Measure |
If Continuous Variable and/or Ratio is chosen, what would be the
range of the score(s)?
|
Number of performance rates to be
submitted
|
Indicate an Overall Performance Rate
|
Is the Measure Risk-Adjusted
|
If risk-adjusted, indicate which score is risk-adjusted |
Please indicate which specialty/specialties this measure applies
to |
|
CUHSM3 |
CAHPS Clinician/Group Surveys - (Adult Primary Care, Pediatric
Care, and Specialist Care Surveys) |
•Adult Primary Care Survey: 37 core and 64 supplemental question
survey of adult outpatient primary care patients.
Pediatric Care Survey: 36 core and 16 supplemental question
survey of outpatient pediatric care patients.
Specialist Care Survey: 37 core and 20 supplemental question
survey of adult outpatients specialist care patients.
Level of analysis for each of the 3 surveys: group practices,
sites of care, and/or individual clinicians |
The measure’s denominator is the number of survey respondents.
The target populations for the surveys are patients who have had
at least one visit to the selected provider in the target
12-month time frame. This time frame is also known as the look
back period. The sampling frame is a person-level list and not a
visit-level list. |
The top box numerator for the Overall Rating of Provider is the
number of respondents who answered 9 or 10 for the item, with 10
indicating “Best provider possible”. |
The following are excluded when constructing the sampling frame:
• Patients that had another member of their household already
sampled.
• Patients who are institutionalized (put in the care of a
specialized institution) or deceased. |
None |
None |
Survey |
No |
5 |
Person and Care-giver-Centered Experiences and Outcomes |
NQS Domain assignment aligns with NQF defined 'National Quality
Strategy Priority' |
Outcome |
N/A |
Patient Reported Outcome |
No |
Yes |
No |
No |
N/A |
1 |
N/A |
Y |
#1 |
All |
|
CUHSM4 |
CAHPS Health Plan Survey v 4.0 - Adult questionnaire |
30-question core survey of adult health plan members that
assesses the quality of care and services they receive. Level of
analysis: health plan – HMO, PPO, Medicare, Medicaid, commercial |
The measure’s denominator is the number of survey respondents
who answered the question. The target population for the survey
includes all individuals who have been enrolled in a health plan
for at least 6 (Medicaid) or 12 (Commercial) months with no more
than one 30-day break in enrollment. Denominators will vary by
item and composite. |
The top box numerator for each of the four Overall Ratings items
is the number of respondents who answered 9 or 10 for the item;
with a 10 indicating the “Best possible.” |
Individuals are excluded from the survey target population if:
1) They were not continuously enrolled in the health plan
(excepting an allowable enrollment lapse of less than 30 days).
2) Their primary health coverage is not through the plan.
3) Another member of their household has already been sampled.
4) They have been institutionalized (put in the care of a
specialized institution) or are deceased. |
None |
None |
Survey |
No |
6 |
Person and Care-giver-Centered Experiences and Outcomes |
NQS Domain assignment aligns with NQF defined 'National Quality
Strategy Priority' |
Outcome |
N/A |
Patient Reported Outcome |
No |
Yes |
No |
No |
N/A |
1 |
N/A |
Y |
#1 |
All |
|
CUHSM6 |
Adherence to Mood Stabilizers for Individuals with Bipolar I
Disorder |
Percentage of individuals at least 18 years of age as of the
beginning of the measurement period with schizophrenia or
schizoaffective disorder who had at least two prescription drug
claims for antipsychotic medications and had a Proportion of
Days Covered (PDC) of at least 0.8 for antipsychotic medications
during the measurement period (12 consecutive months). |
Individuals at least 18 years of age as of the beginning of the
measurement period with bipolar I disorder and at least two
prescription drug claims for mood stabilizer medications during
the measurement period (12 consecutive months). |
Individuals with bipolar I disorder who had at least two
prescription drug claims for mood stabilizer medications and
have a PDC of at least 0.8 for mood stabilizer medications. |
None |
None |
None |
Administrative clinical data, Prescription Drug Event Data
Elements |
No |
1880 |
Patient Safety |
NQS Domain assignment aligns with NQF defined 'National Quality
Strategy Priority' |
High Priority |
Patient Safety |
Process |
No |
Yes |
No |
No |
N/A |
1 |
N/A |
Y |
#1 |
Behavioral Health |
|
CUHSM8 |
Cardiovascular Health Screening for People With Schizophrenia or
Bipolar Disorder Who Are Prescribed Antipsychotic Medications |
The percentage of individuals 25 to 75 years of age with
schizophrenia or bipolar disorder who were prescribed any
antipsychotic medication and who received a cardiovascular
health screening during the measurement year. |
Individuals ages 25 to 75 years of age by the end of the
measurement year with a diagnosis of schizophrenia or bipolar
disorder who were prescribed any antipsychotic medication during
the measurement year. |
Individuals who had one or more LDL-C screenings performed
during the measurement year. |
Individuals are excluded from the denominator if they were
discharged alive for a coronary artery bypass graft (CABG) or
percutaneous coronary intervention (PCI) (these events may occur
in the measurement year or year prior to the measurement year),
or diagnosed with ischemic vascular disease (IVD) (this
diagnosis must appear in both the measurement year and the year
prior to the measurement year), chronic heart failure, or had a
prior myocardial infarction (identified in the measurement year
or as far back as possible). |
None |
None |
Administrative clinical data, Prescription Drug Event Data
Elements |
No |
1927 |
Patient Safety |
NQS Domain assignment aligns with NQF defined 'National Quality
Strategy Priority' |
High Priority |
Patient Safety |
Process |
No |
Yes |
No |
No |
N/A |
1 |
N/A |
Y |
#1 |
Behavioral Health, Cardiovascular |
