IT-1.31: Asthma Medication Management
Measure Title / IT-1.31 Medication Management for People with Asthma (MMA) /Description / The percentage of patients 5-64 years of age during the measurement period who were identified as having persistent asthma and were dispensed appropriate medications that they remained on during the treatment period.
Two rates are reported:
1. The percentage of patients who remained on an asthma controller medication for at least 50% of their treatment period.
2. The percentage of patients who remained on an asthma controller medication for at least 75% of their treatment period.
NQF Number / 1799
Measure Steward / National Committee for Quality Assurance
Link to measure citation / http://www.qualityforum.org/QPS/1799 and http://www.qualitymeasures.ahrq.gov/content.aspx?id=47172 and http://www.qualitymeasures.ahrq.gov/content.aspx?id=47173
Measure type / Stand-alone (SA)
Performance and Achievement Type / Pay for Performance (P4P) – Improvement Over Self (IOS)
DY4 / DY5
Achievement Level Calculation / Baseline + 5% *(performance gap)
=
Baseline + 5% *(100% – Baseline rate) / Baseline + 10% *(performance gap)
=
Baseline + 10% *(100% – Baseline rate)
DSRIP-specific modifications to Measure Steward’s specification / None.
Denominator Description / Patients 5–64 years of age during the measurement period who were identified as having persistent asthma.
Denominator Inclusions / Identify patients as having persistent asthma who met at least one of the following criteria during both the measurement period and the 12-months prior to the measurement period. Criteria need not be the same across both the measurement period and the prior 12-month period.
· At least one emergency department (ED) visit with asthma as the principal diagnosis
· At least one acute inpatient encounter with asthma as the principal diagnosis
· At least four outpatient asthma visits on different dates of service with asthma as one of the listed diagnoses and at least two asthma medication dispensing events
· At least four asthma medication dispensing events
Denominator Exclusions / · Exclude any patients who had any diagnosis of Emphysema, , COPD, Chronic Bronchitis, Cystic Fibrosis or Acute Respiratory Failure any time during the patient’s history through the end of the measurement year (e.g., December 31).
· Exclude any patients who have no asthma controller medications (Table ASM-D) dispensed during the measurement year.
Denominator Size / Providers must report a minimum of 30 cases per measure during a 12-month measurement period (15 cases for a 6-month measurement period)
· For a measurement period (either 6 or 12 months) where the denominator size is less than or equal to 75, providers must report on all cases. No sampling is allowed.
· For a measurement period (either 6 or 12 months) where the denominator size is less than or equal to 380 but greater than 75, providers must report on all cases (preferred, particularly for providers using an electronic health record) or a random sample of not less than 76 cases.
· For a measurement period (either 6 or 12-months) where the denominator size is greater than 380, providers must report on all cases (preferred, particularly for providers using an electronic health record) or a random sample of cases that is not less than 20% of all cases; however, providers may cap the total sample size at 300 cases.
Numerator Description / This measure uses 2 different numerators:
(1) Medication Compliance of 50%: Number of patients who achieved a PDC of at least 50% for their asthma controller medications during the measurement year.
(2) Medication Compliance of 75%: Number of patients who achieved a PDC of at least 75% for their asthma controller medications during the measurement year.
PDC equals (a) the proportion of days covered by at least one asthma controller medication prescription (b) divided by the number of days in the treatment period.
Numerator Inclusions / The Measure Steward does not identify specific numerator inclusions beyond what is described in the numerator description.
Numerator Exclusions / The Measure Steward does not identify specific numerator exclusions beyond what is described in the numerator description.
Setting / Ambulatory
Data Source / Administrative claims data, electronic clinical data, electronic clinical data: pharmacy
Allowable Denominator Sub-sets / All denominator subsets are permissible for this outcome
09/24/14