Posted on Leave a comment

Medicaid Acronym of the Day – CCS

Cervical Cancer Screening – The percentage of women 21–64 years of age who were screened for cervical cancer using either of the following criteria:

• Women age 21–64 who had cervical cytology performed every 3 years.

• Women age 30–64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years.

Further reading 

http://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality/2016-table-of-contents/cervical-cancer-screening

Posted on Leave a comment

Medicaid Acronym of the Day – ART

Disease-Modifying AntiRheumatic Drug Therapy for Rheumatoid Arthritis – The percentage of members who were diagnosed with rheumatoid arthritis and who were dispensed at least one ambulatory prescription for a disease-modifying antirheumatic drug (DMARD).

Further reading 

http://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality/2016-table-of-contents/dmards

Posted on Leave a comment

Medicaid Acronym of the Day – AMM

Antidepressant Medication Management – The percentage of members 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression and who remained on an antidepressant medication treatment. Two rates are reported.

• Effective Acute Phase Treatment. The percentage of members who remained on an antidepressant medication for at least 84 days (12 weeks).

• Effective Continuation Phase Treatment. The percentage of members who remained on an antidepressant medication for at least 180 days (6 months).

Further reading 

 http://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality/2016-table-of-contents/antidepressant

Posted on Leave a comment

Medicaid Acronym of the Day – AAB

Avoidance of Antibiotic Treatment for Adults with Acute Bronchitis – The percentage of adults 18–64 years of age with a diagnosis of acute bronchitis who 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 adults with acute bronchitis (i.e., the proportion for whom antibiotics were not prescribed).

Further reading 

 https://www.premera.com/documents/032655.pdf

Posted on Leave a comment

Medicaid Acronym of the Day – QA/QI

Quality Assurance/Quality Improvement – Related to clinical requirements and best practices. Whereas quality assurance is typically defined as systematic inculcation of safety and quality processes, quality improvement suggests a retrospective and self-reflective effort to identify areas of suboptimal performance and dedication to improving them.

Further reading 

https://www.health.ny.gov/health_care/managed_care/docs/quality_strategy.pdf