How is this measured?

WA-APCD  Accountable  Communities of Health (ACH)  QUALITY  MEASURES

Measure Name

Measure Name on Website

Source

ReportingUnit

Population

 Description

Cost and Value

Ambulatory Care (AMB) – ED visits

Emergency Room Visits Per 1,000 Persons

Claims

Visits Per 1,000

Persons

Medicaid

Number of emergency departmentvisits per 1,000 population.

Good Treatment Results

Adult Mental Health Status

Poor Mental, Emotional Health

DOH - BRFSS

Percentage

All

Weighted, age-adjusted percent of adults ages 18 andolder who answer “14 or more days” in response to the question, “Nowthinking about your mental health,which includes stress, depression,and problems with emotions, for howmany days during the past 30 dayswas your mental health not good?”.

30-day Psychiatric Inpatient Readmissions (PCR-P)

Avoid Return to Hospital for Mental Health Condition

DSHS

RatioObserved toExpected

  Medicaid

Adults 18 years andolder, the proportion of acute inpatientpsychiatric stays during measurement year that were followedby an acute psychiatric readmission within 30 days.

Adult Tobacco Use

Adults Who Smoke

DOH - BRFSS

Percentage

All

Weighted, age-adjusted percent of adults 18 yearsand older who answer “yes” to having smoked at least 100 cigarettes in their entire life and now smoke "every day" or"some days".

Unintended Pregnancies

Unintended Pregnancies

DOH - PRAMS

Percentage

All

Percent of pregnancies (including all abortions and births) that were unintended at the time of conception.

COMING SOON

Obesity: Youth

Teen Obesity

DOH- HYS

Percentage

All

10th graders who based on self-reported height and weight have a body mass index of greater than or equal to 30.

Obesity: Adult

Adult Obesity

DOH-BRFSS

Percentage

All

Weighted, age-adjusted percent of adults 18 years and older who based on self-reported height and weight have a body mass index of greater than or equal to 30.

Youth Substance Use

Teens Who Smoke Cigarettes

DOH – HYS

Percentage

All

10th graders who smoked cigarettes in the past 30 days.

Youth Substance Use

Teens Who Use Vape Products

DOH-HYS

Percentage

All

10th graders who used electronic vapor products in the past 30 days.

Measure Name

Measure Name on Website

Source

Reporting Unit

Population

Description

Keeping Patients Safe

Use of Imaging Studies for Low Back Pain (LBP)

Testing for Cause of Back Pain

Claims

Percentage

Medicaid

Adults18 to 50 years, with a primary diagnosisof low back pain who did not have animaging study (plain X-ray, MRI,or CT scan) within 28 days of the diagnosis. A higher score indicates better performance.

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB)

Avoid Wrong Medication for Bronchitis

Claims

Percentage

Medicaid

Adults 18 to 64years, with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription.

Annual Monitoring forPatients on PersistentMedications – angiotensin converting enzyme (ACE) inhibitorsor angiotensin receptor blockers (ARB) (MPM)

Checking Patients Who NeedOngoing Medications

Claims

Percentage

Medicaid

Adults 18 yearsand older who received at least 180treatment days of ambulatory medicationtherapy for ACE/ARB during the measurement year and received at least one therapeutic monitoring event for ACE/ARB in the measurement year.

Appropriate Testing for Children With Pharyngitis (CWP)

Treating Children with ThroatInfections

Claims

Percentage

Medicaid

Children 3 to 18 yearswho were diagnosed with pharyngitis,dispensed an antibiotic, and received a group A streptococcus (strep) test for the episode. A higher rate represents better performance (i.e., appropriate testing).

Ambulatory Care: Avoidable Emergency Department Utilization

Avoid Unnecessary Emergency Visits

Claims

Rate per 1,000

MemberYears

All

Emergency department visits for conditionsthat could have been more appropriatelymanaged by or referred to a primary care provider.

COMING SOON

Opioid Prescribing: Transition to Chronic Prescription

Prescribe Addictive Opioids for Too Long

 

DOH – PMP

Rate per 1000 population

All

Age- and sex-adjusted rate of patients with at least one opioid prescription in the previous calendar quarter (with no opioid prescription in the prior quarter) who in the current calendar quarter have a greater than 60 day supply of opioids.

Opioid Prescribing: Days Supply Prescription for Adults

Prescribe Large Supply of Addictive Opioids to New Patients

DOH-PMP

Percentage

All

Age- and sex-adjusted rate of adults 18 years and older with no prescribed opioids in the prior calendar quarter who in the current calendar quarter have a greater than 7 day supply.

Opioid Prescribing: Days Supply Prescription for Children

Prescribe Large Supply of Addictive Opioids to New Patients

DOH-PMP

Percentage

All

Age- and sex-adjusted rate of children/adolescents aged 17 years and younger with no prescribed opioids in the prior calendar quarter who in the current calendar quarter have a greater than 7 day supply.

Opioid Prescribing: High Dose Prescription

Prescribe High Doses of Addictive Opioids

DOH-PMP

Percentage

All

Age- and sex-adjusted rate of patients prescribed more than 60 days of opioids in the current calendar quarter at more than 50 mg per day or more than 90 mg per day of morphine equivalent dosing (MED).

 

Measure Name

Measure Name on Website

Source

ReportingUnit

Population

Description

Get the Right Care

Comprehensive Diabetes Care

– Hemoglobin A1c (HbA1c) Testing (CDC)

Diabetes Care: Blood Sugar Tested

Claims

Percentage

Medicaid

Adults 18 to 75years with diabetes (Type 1 and/or Type 2)who had an HbA1c test during the measurement year.

Comprehensive Diabetes Care

– Medical Attention forNephropathy (CDC)

Diabetes Care: Check for Kidney Disease

Claims

Percentage

Medicaid

Adults 18 to 75years with diabetes (Type 1 and/or Type 2)who received a nephropathy screening ormonitoring test or had evidence ofnephropathy during the measurement yearor the year prior.

Comprehensive Diabetes Care

– Eye Exam (Retinal) Performed (CDC)

Diabetes Care: Eye Exam to Check for Vision Loss

Claims

Percentage

Medicaid

Adults 18 to 75years with diabetes (Type 1 and/or Type 2)who had an eye exam (retinal) during the measurement year or the year prior.

Proportion of Days Covered – Diabetes All Class (DR)

Diabetes Care: Getting Medications to Control Blood Sugar

Claims

Percentage

Medicaid

Adults 18 yearsand older, who met the proportion of dayscovered (PDC) threshold of 80% for diabetesroll-up medications.

Antidepressant Medication Management: Effective Acute Phase Treatment (AMM)

Mental Health Care: Getting Anti-depressant Medications

Claims

Percentage

Medicaid

Adults 18 years and older, who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment for at least 12 weeks.

Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)

Asthma and Lung Care: Testing for Lung Disease

Claims

Percentage

Medicaid

Adults 40 yearsand older with a new diagnosisof COPD or newly active COPD, whoreceived appropriate spirometry testing to confirm the diagnosis.

Medication Management for People with Asthma (MMA)

Asthma and Lung Care: Getting Medications for Asthma

Claims

Percentage

Medicaid

Adults and children 5 to 85years of age who were identified ashaving persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75% of their treatment period. (For Medicaid, this measure is reported for adults and children 5 to 64 years.)

Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adult Admission Rate 

Asthma and Lung Care: Fewer Hospital Stays Due to Good Lung Care

AHRQ

Rate per 1,000

MemberYears

Medicaid

Adults 40 years and older,who had an admission with a principaldiagnosis of chronic obstructive pulmonary disease (COPD) or asthma.

Proportion of Days Covered –Renin Angiotensin SystemAntagonists (RASA)

Heart Care: Getting Medications to Lower Blood Pressure

Claims

Percentage

Medicaid

Adults 18 yearsand older, who met the proportion of dayscovered (PDC) threshold of 80% for ReninAngiotensin System Antagonists.

Proportion of Days Covered – Statins (STA)

Heart Care: Getting Medications to Lower Cholesterol

Claims

Percentage

Medicaid

Adults 18 years and older, who met the proportion of days covered (PDC) threshold of 80% for statins.

COMING SOON

Early Prenatal Care

Check-Ups During Pregnancy

DOH – birth certificate

Percentage

All

Women who received first trimester prenatal care.

Getting in to See the Doctor

Well-Child Visits in the First 15Months of Life (W15)

Children Get Care: Infants Get Regular Check-ups

Claims

Percentage

Medicaid

Children who turned 15months old during the measurement yearand had six or more well-child visitswith a PCP during their first 15 months oflife.

Well-Child Visits in the Third,Fourth, Fifth, and Sixth Yearsof Life (W34)

Children Get Care: Children Get Regular Check-ups

Claims

Percentage

Medicaid

Children 3 to 6years who had one or more well-child visitswith a PCP during the measurement year.

Children and Adolescents’ Access to Primary Care Practitioners (CAP)

Children Get Care: Having a Primary Care Visit Yearly

Claims

Percentage

Medicaid

Children aged 12months to 19 years who had a preventive or ambulatory care visit.

Substance Use Disorder (SUD) Service Penetration

Children Get Care: Getting Substance Abuse Services

DSHS

Percentage

Medicaid

Adolescents 12 to 17 years with a SUD treatment need who received SUD treatment in the measurement year.

Mental Health Service Penetration

Children Get Care: Getting Mental Health Services

DSHS

Percentage

Medicaid

Children 6 to 17 years with a mental health service need who received mental health services in the measurement year.

Mental Health Service Penetration

Adults Get Care: Getting Mental Health Services

DSHS

Percentage

Medicaid

Adults 18 years and older with a mental health service need who received mental health services in the measurement year.

Substance Use Disorder (SUD) Service Penetration

Adults Get Care: Getting Substance Abuse Services

DSHS

Percentage

Medicaid

Adults 18 years and older with a SUD treatment need who received SUD treatment in the measurement year.

Adults Access to Preventive/Ambulatory Health Services (AAP)

Adults Get Care: Having a Doctor/Office Visit Yearly

Claims

Percentage

Medicaid

Adults 20 to 64 years who had a preventive or ambulatory care visit during the measurement year.

Measure Name

Measure Name on Website

Source

ReportingUnit

Population

Description

Preventing Illness

Childhood Immunization Status (CIS) Combination 10

Help Children Stay Healthy: Children Get Immunization Shot

DOH

Percentage

All

Children 2 years of age in the measurement year who received 4 DTaP/DT/Td, 3 Hib, 3 polio, 3 Hep B, 1 MMR, 1 Varicella, 1 Hep A, 2 flu, 4 PCV, 2 rotavirus by their 2nd birthday.

Immunizations for Adolescents (IMA)

Help Children Stay Healthy: Teenagers Get Immunization Shots

DOH

Percentage

All

Children 13 years of age in the measurement year who received 1 Tdap, 1 MCV, and 3 doses of HPV by their 13th birthday.

Immunizations for Adolescents (IMA)

Help Children Stay Healthy: Girls Get HPV Shot to Prevent Infection and Disease

DOH

Percentage

All

Female adolescents 13 years old in the measurement year who received 3 doses of human papillomavirus (HPV) vaccine by their 13th birthday.

Immunizations for Adolescents (IMA)

Help Children Stay Healthy: Boys Get HPV Shot to Prevent Infection and Disease

DOH

Percentage

All

Male adolescents 13 years old in the measurement year who received 3 doses of the human papillomavirus (HPV) vaccine by their 13th birthday.

Immunization for Influenza

Help Children Stay Healthy: Children Get Flu Shot

DOH

Percentage

All

Children 6 months through 17 years who are active patients in the Washington Immunization Information System who received 1 or more flu vaccinations from Oct 1st, through Dec 31st of the measurement year.

 

Oral Health: Primary Caries Prevention Offered by Primary Care

Help Children Stay Healthy: Care to Prevent Cavities

HCA

Percentage

Medicaid

Children less than 6 years who received a fluoride varnish application during a routine preventive health visit with a primary care provider.

Audiological Evaluation No Later Than 3 Months of Age

Help Children Stay Healthy: Testing Hearing Loss in Infants

DOH

Percentage

All

Newborns who didnot pass a hearing screening and have an audiological evaluation no later than 3 months of age.

Breast Cancer Screening (BCS)

Checking for Cancer: Checking for Breast Cancer

Claims

Percentage

Medicaid

Women 50 to 74years, who had a mammogram to screen forbreast cancer in the past two years.

Cervical Cancer Screening (CCS)

Checking for Cancer: Checking for Cervical Cancer

Claims

Percentage

Medicaid

Women 21 to 64 years who had cervical cytology performed every 3 years OR women 30 to 64 years who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years.

Immunization for Influenza

Right Care to Prevent Illness: Adults Get Flu Shot

DOH

Percentage

All

Adults aged 18 years and older who self-reported having received an influenza immunization during the past 12 months.

Chlamydia Screening in Women (CHL)

Right Care to Prevent Illness: Check for Chlamydia Infection in Younger Women

Claims

Percentage

Medicaid

Women 16 to 24years who were identified as sexually active and who had at least one test for chlamydia during the measurement year.

Pneumococcal Vaccination Status for Older Adults (PNU)

Right Care to Prevent Illness: Older Adults Get Pneumonia Shot

DOH

Percentage

All

Adults 65 years and older who self-reported ever having received a pneumococcal vaccine.

 

WA-APCD  INSURANCE  MARKET  SECTOR  QUALITY  MEASURES

Measure Name

Measure Name on Website

Source

ReportingUnit

Population

Description

Cost and Value

Medicaid Per Enrollee Spending

Yearly Healthcare Costper Medicaid Enrollee

HCA

Per Enrollee Per Year

Medicaid

Total Medicaid spending in the calendar yeardivided by the total number of Medicaidbeneficiaries in the calendar year.

Public Employee and Dependent per Enrollee Spending

Yearly Healthcare Costper Public Employee Program Enrollee (PEBB)

HCA

Per Enrollee Per Year

PEBB

Total state spending for public employees anddependents in the calendar year divided by the total number of beneficiaries in the calendar year.

Ambulatory Care (AMB) – ED visits

Emergency Room Visits Per 1,000 Persons

Claims

Visits Per 1,000

Persons

CommercialExchange Medicaid

Number of emergency department visits per1,000 population.

Good Treatment Results

Plan all-Cause Readmissions (PCR)

Avoid Return to Hospital

Claims

RatioObserved toExpected

Commercial

Adults 18 to 64 years who had an acute inpatient stay during the measurement year that was followed by unplanned acute readmissionfor any diagnosis within 30 days.

30-day Psychiatric Inpatient Readmissions (PCR-P)

Avoid Return to Hospital for Mental Health Condition

DSHS

Ratio Observed to Expected

Medicaid

Adults 18 years andolder, the proportion of acute inpatientpsychiatric stays during measurement year that were followedby an acute psychiatric readmission within 30 days.

Controlling High Blood Pressure (CBP)

Controlling High Blood Pressure

NCQA

Percentage

Commercial Exchange Medicaid

Adults 18 to 85 years of age who had a diagnosis of hypertension and whose blood pressure (BP) was adequately controlled:  1) 18 to 59 years <140/90 mm Hg; 2) 60 to 85 years with diabetes, < 140/90 mm Hg; 3) 60-85 years without diabetes, < 150/90 mm Hg.                                       

Comprehensive Diabetes Care (CDC) – Hemoglobin A1c (HbA1c) Poor Control

Blood Sugar in PoorControl - Diabetes

NCQA

Percentage

Commercial

Medicaid

Adults 18 to 75 years with diabetes (type 1 and type 2) whose mostrecent HbA1c level during the measurementyear was greater than 9.0%,missing a result, or HbA1c test wasnot done during the measurement year.

Comprehensive Diabetes Care (CDC) - Blood Pressure Control (<140/90 mmHg)

Blood Pressure in GoodControl - Diabetes

NCQA

Percentage

Commercial

Medicaid

Adults 18 to 75 years with diabetes (type 1 and type 2) whose mostrecent blood pressure reading taken during the measurement year is <140/90 mm Hg.

Keeping Patients Safe

Use of Imaging Studies for Low Back Pain (LBP)

Testing for Cause of Back Pain

Claims

Percentage

CommercialExchange Medicaid

Adults 18 to 50 years with a primary diagnosis of low backpain who did not have an imaging study (plain X-ray, MRI, or CT scan) within 28days of the diagnosis. A higherscore indicates better performance.

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB)

Avoid Wrong Medicationfor Bronchitis

Claims

Percentage

CommercialExchange Medicaid

Adults 18 to 64 years,with a diagnosis of acute bronchitis whowere not dispensed an antibiotic prescription.

Annual Monitoring forPatients on PersistentMedications – angiotensin converting enzyme (ACE) inhibitorsor angiotensin receptor blockers (ARB) (MPM)

Checking Patients WhoNeed OngoingMedications

Claims

Percentage

CommercialExchange Medicaid

Adults 18 yearsand older who received at least 180treatment days of ambulatory medicationtherapy for ACE/ARB during the measurement year and received at least one therapeutic monitoring event for ACE/ARB in the measurement year.

Appropriate Testing for Children with Pharyngitis (CWP)

Treating Children withThroat Infections

Claims

Percentage

CommercialExchange Medicaid

Children 3 to 18 yearswho were diagnosed with pharyngitis,dispensed an antibiotic, and received a group A streptococcus (strep) test for the episode. A higher rate represents better performance (i.e., appropriate testing).

Ambulatory Care: Avoidable Emergency Department Utilization

Avoid Unnecessary Emergency Visits

Claims

Rate per 1,000

MemberYears

CommercialExchange Medicaid

Emergency department visits for conditionsthat could have been more appropriatelymanaged by or referred to a primary care provider.

Get the Right Care

Comprehensive Diabetes Care

– Hemoglobin A1c (HbA1c) Testing (CDC)

Diabetes Care: Blood Sugar Tested

Claims

Percentage

CommercialExchange Medicaid

Adults 18 to 75 years with diabetes (Type 1 and/or Type 2) who had an HbA1c test during the measurement year.

Comprehensive Diabetes Care

– Medical Attention forNephropathy (CDC)

Diabetes Care: Check for Kidney Disease

Claims

Percentage

CommercialExchange Medicaid

Adults 18 to 75years with diabetes (Type 1 and/or Type 2)who received a nephropathy screening ormonitoring test or had evidence ofnephropathy during the measurement yearor the year prior.

Comprehensive Diabetes Care (CDC) – Eye Exam (Retinal) Performed

Diabetes Care: Eye Exam to Check for Vision Loss

Claims

Percentage

Commercial Exchange Medicaid

Adults 18 to 75years with diabetes (Type 1 and/or Type 2)who had an eye exam (retinal) during the measurement year or the year prior.

Proportion of Days Covered – Diabetes All Class (DR)

Diabetes Care: Getting Medications to Control Blood Sugar

Claims

Percentage

Commercial Exchange Medicaid

Adults 18 yearsand older, who met the proportion of dayscovered (PDC) threshold of 80% for diabetesroll-up medications.

Antidepressant MedicationManagement: Effective Acute Phase Treatment (AMM)

Mental Health Care: Getting Anti-depressant Medications

Claims

Percentage

Commercial Exchange Medicaid

Adults 18 yearsand older, who were treated withantidepressant medication, had a diagnosisof major depression, and who remained onan antidepressant medication treatment for at least 12 weeks.

Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)

Asthma and Lung Care: Testing for Lung Disease

Claims

Percentage

CommercialExchange Medicaid

Adults 40 yearsand older with a new diagnosisof COPD or newly active COPD, whoreceived appropriate spirometry testing to confirm the diagnosis.

Medication Management for People with Asthma (MMA)

Asthma and Lung Care: Getting Medications for Asthma

Claims

Percentage

CommercialExchange Medicaid

Adults and children 5 to 85years of age who were identified ashaving persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75% of their treatment period. (For Medicaid, this measure is reported for adults and children 5 to 64 years.)

Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adult Admission Rate 

Asthma and Lung Care: Fewer Hospital Stays Due to Good Lung Care

AHRQ

Rate per 1,000

Member Years

Commercial Exchange Medicaid

Adults 40 years and older,who had an admission with a principaldiagnosis of chronic obstructive pulmonary disease (COPD) or asthma.

Statin Therapy for Patients with Cardiovascular Disease

Heart Care: Getting and Taking Medications for Heart Disease

Claims

Percentage

Commercial

Exchange

Medicaid

Males 21 to 75 years of age and females 40 to 75 years who have clinical atherosclerotic cardiovascular disease and who received and adhered to statin therapy.

Proportion of Days Covered –Renin Angiotensin SystemAntagonists (RASA)

Heart Care: Getting Medications to Lower Blood Pressure

Claims

Percentage

Commercial Exchange Medicaid

Adults 18 yearsand older, who met the proportion of dayscovered (PDC) threshold of 80% for ReninAngiotensin System Antagonists.

Proportion of Days Covered – Statins (STA)

Heart Care: Getting Medications to Lower Cholesterol

Claims

Percentage

Commercial Exchange Medicaid

Adults 18 years and older, who met the proportion of days covered (PDC) threshold of 80% for statins.

Getting in to See the Doctor

Well-Child Visits in the First 15Months of Life (W15))

Children Get Care: Infants Get Regular Check-ups

Claims

Percentage

CommercialExchange Medicaid

Children who turned 15months old during the measurement yearand had six or more well-child visitswith a PCP during their first 15 months oflife.

Well Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life (W34)

Children Get Care: Children Get Regular Check-ups

Claims

Percentage

CommercialExchange Medicaid

Children 3 to 6years who had one or more well-child visitswith a PCP during the measurement year.

Children and Adolescents’ Access to Primary Care Practitioners (CAP)

Children Get Care: Having a Primary Care Visit Yearly

Claims

Percentage

CommercialExchange Medicaid

Children aged 12months to 19 years who had a preventive or ambulatory care visit.

Substance Use Disorder (SUD) Service Penetration

Children Get Care: Getting Substance Abuse Services

DSHS

Percentage

Medicaid

Adolescents 12 to 17 years with a SUD treatment need who received SUD treatment in the measurement year.

Mental Health Service Penetration

Children Get Care: Getting Mental Health Services

DSHS

Percentage

Medicaid

Children 6 to 17 years with a mental health service need who received mental health services in the measurement year.

Mental Health Service Penetration

Children Get Care: Getting Mental Health Services

Claims

Percentage

Commercial

Children 6 to 17 years with a mental health service need who received mental health services in the measurement year.

Adults Access to Preventive/Ambulatory Health Services (AAP)

Adults Get Care: Having a Doctor/Office Visit Yearly

Claims

Percentage

Commercial Exchange Medicaid

Adults 20 to 64 yearsand older who had a preventive or ambulatory care visit during the measurement year.

Substance Use Disorder (SUD) Service Penetration

Adults Get Care: Getting Substance Abuse Services

DSHS

Percentage

Medicaid

Adults 18 years and older with a SUD treatment need who received SUD treatment in the measurement year.

Mental Health Service Penetration

Adults Get Care: Getting Mental Health Services

DSHS

Percentage

Medicaid

Adults 18 years and older with a mental health service need who received mental health services in the measurement year.

Mental Health Service Penetration

Adults Get Care: Getting Mental Health Services

DSHS

Percentage

Commercial

Adults 18 years and older with a mental health service need who received mental health services in the measurement year.

Preventing Illness

Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)

Help Children Stay Healthy: Checking if Weight is a Health Problem – Children

NCQA

Percentage

Commercial

Medicaid

Children/adolescents 3 to 17 years who had an outpatient visit with a primary care provider orOB/GYN during the measurement year and had evidence of: (1) Body mass index (BMI) percentile documentation; (2) counselingfor nutrition; and (3) counseling for physicalactivity.

Oral Health: Primary Caries Prevention Offered by Primary Care

Help Children Stay Healthy: Care to Prevent Cavities

HCA

Percentage

Medicaid

Children less than 6 years who received a fluoride varnish application during a routine preventive health visit with a primary care provider.

Breast Cancer Screening (BCS)

Checking for Cancer: Checking for Breast Cancer

Claims

Percentage

CommercialExchange Medicaid

Women 50 to 74years, who had a mammogram to screen forbreast cancer in the past two years.

Cervical Cancer Screening (CCS)

Checking for Cancer: Checking for Cervical Cancer

Claims

Percentage

CommercialExchange Medicaid

Women 21 to 64 years who had cervical cytology performed every 3 years OR women 30 to 64 years who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years.

Colorectal Cancer Screening (COL)

Checking for Cancer: Checking for Colorectal Cancer

NCQA

Percentage

Commercial

Adults 50 to 75 years ofage who had appropriate screening forcolorectal cancer: annual fecal occult blood test, flexible sigmoidoscopy every 5 years, colonoscopy every 10 years, computed tomography colonography every 5 years, stool DNA test every 3 years.

Right Care to Prevent Illness

Adult BMI Assessment (ABA)

Right Care to Prevent Illness: Checking if Weight is a Health Problem - Adults

NCQA

Percentage

Commercial

Medicaid

Adults 18 to 74 years who had an outpatient visit in the past 2 years and had their BMI documented.

Chlamydia Screening in Women (CHL)

Right Care to Prevent Illness: Check for Chlamydia Infection in Younger Women

Claims

Percentage

Commercial Exchange Medicaid

Women 16 to 24years who were identified as sexually active and who had at least one test for chlamydia during the measurement year.