Year: 2017

The National Health Expenditure Accounts (NHEA) are the official estimates of total health care spending in the United States. Dating back to 1960, the NHEA measures annual U.S. expenditures for health care goods and services, public health activities, government administration, the net cost of health insurance, and investment related to health care. The data are presented by type of service, sources of funding, and type of sponsor.

U.S. health care spending grew 5.8 percent in 2015, reaching $3.2 trillion or $9,990 per person. As a share of the nation’s Gross Domestic Product, health spending accounted for 17.8 percent.

 

Further reading –

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet.html

Osteoporosis Management in Women Who Had a Fracture – The percentage of women 67–85 years of age who suffered a fracture and who had either a bone mineral density (BMD) test or prescription for a drug to treat osteoporosis in the six months after the fracture.

 

Further reading –

https://www.qualitymeasures.ahrq.gov/summaries/summary/49727

Statin Therapy for Patients With Cardiovascular Disease –

The percentage of males 21–75 years of age and females 40–75 years of age who were identified as having clinical atherosclerotic cardiovascular disease (ASCVD) and met the following criteria.

Members who were dispensed at least one high or moderate-intensity statin medication during the measurement year.
Members who remained on a high or moderate-intensity statin medication for at least 80% of the treatment period.

 

Further reading –

http://www.rxeconsult.com/healthcare-articles/HEDIS-2017-Measure-For-Statin-Therapy-For-Patients-With-Cardiovascular-Disease-SPC-1271/

Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents  – The percentage of members 3–17 years of age who had an outpatient visit with a PCP or OB/GYN and who had evidence of the following during the measurement year.

•  BMI percentile documentation*.

•  Counseling for nutrition.

•  Counseling for physical activity.

 

* Because BMI norms for youth vary with age and gender, this measure evaluates whether BMI percentile is assessed rather than an absolute BMI value.

 

Further reading –

https://providers.amerigroup.com/ProviderDocuments/KSKS_HEDIS_WellChildVisitsWeightAssessment.pdf

Well-Care Visits in the First 15 Months of Life – The percentage of members who turned 15 months old during the measurement year and who had the following number of well-child visits with a PCP during their first 15 months of life: no well child visits, 1 well-child visit, 2 well-child visits, 3 well-child visits, 4 well-child visits, 5 well-child visits, 6 or more well-child visits.

Further reading –

https://www.qualitymeasures.ahrq.gov/summaries/summary/49819/wellchild-visits-in-the-first-15-months-of-life-percentage-of-members-who-turned-15-months-old-during-the-measurement-year-and-who-had-the-following-number-of-wellchild-visits-with-a-pcp-during-their-first-15-months-of-life-zero-one-two-three-four-five-six-or-

Upper Respiratory Infection – Appropriate Treatment for Children With Upper Respiratory Infection . The percentage of children 3 months–18 years of age who were given a diagnosis of upper respiratory infection (URI) and were not dispensed an antibiotic prescription. *The measure is reported as an inverted rate [1 – (numerator/eligible population)]. A higher rate indicates appropriate treatment of children with URI (i.e., the proportion for whom antibiotics were not prescribed).

Further reading –

https://providers.optimahealth.com/clinicalreference/Pages/Avoidance-of-Antibiotic-Use.aspx

Prenatal and Postpartum Care – The percentage of deliveries of live births between November 6 of the year prior to the measurement year and November 5 of the measurement year. For these women, the measure assesses the following facets of prenatal and postpartum care. • Timeliness of Prenatal Care. The percentage of deliveries that received a prenatal care visit as a member of the organization in the first trimester or within 42 days of enrollment in the organization. Postpartum Care- The percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.

Further reading –

https://www.medicaid.gov/medicaid/quality-of-care/downloads/strategies-to-improve-postpartum-care.pdf

Managed behavioral healthcare organizations (MBHO) can be independent organizations, can be part of a health plan or can be supported by health care providers. All have a common focus: deliver value. Key strategies for accomplishing this include network development, performance measurement, managing utilization, coordinating care and setting payment rates. Managed behavioral healthcare organizations (MBHO) can be independent organizations, can be part of a health plan or can be supported by health care providers. All have a common focus: deliver value.
Key strategies for accomplishing this include network development, performance measurement, managing utilization, coordinating care and setting payment rates.

Further reading –

https://prezi.com/0vo1evondfjr/managed-behavioral-healthcare-organizations-mbho/