State,Domain,Reporting Program,Measure Name,Measure Abbreviation,Measure Type,Rate Definition,FFY,Population,Methodology,State Rate,Number of States Reporting,Median,Bottom Quartile,Top Quartile,Notes,Source,State-Specific Comments,Rate Used in Calculating State Mean and Median
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid only,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and PCCM populations. State reported that rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",No
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,CHIP only,Administrative,#,25,10.6,6.0,16.3,# = Rate not reported because denominator is less than 30,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,45.3,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,61.6,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,CHIP only,Administrative,38.1,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,CHIP only,Administrative,61.9,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,42.9,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,66.5,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,43.8,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,71.6,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,32.7,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,100.0,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,37.3,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data."" State reported the following deviations: Many of the ADHD medications are also used in the treatment of narcolepsy. In order to have a precise ADHD measure, children with narcolepsy were removed from the denominator and both indicators as specified under the optional exclusions for this measure.",No
Alabama,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,49.8,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data."" State reported the following deviations: Many of the ADHD medications are also used in the treatment of narcolepsy. In order to have a precise ADHD measure, children with narcolepsy were removed from the denominator and both indicators as specified under the optional exclusions for this measure.",No
Alabama,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid only,Administrative,46.1,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,28.2,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,27.2,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,CHIP only,Administrative,49.1,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data.""",No
Alabama,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,27.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data.""",No
Alabama,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,24.9,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data.""",No
Alabama,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid only,Administrative,62.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,CHIP only,Administrative,60.9,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid only,Administrative,32.9,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,CHIP only,Administrative,20.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data.""",No
Alabama,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid only,Administrative,87.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid only,Administrative,83.0,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid only,Administrative,85.6,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,CHIP only,Administrative,91.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data.""",No
Alabama,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,CHIP only,Administrative,87.9,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data.""",No
Alabama,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,CHIP only,Administrative,89.9,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data.""",No
Alabama,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid only,Administrative,43.2,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,CHIP only,Administrative,55.5,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data."" State reported the following deviations: ""The specifications note that this measure should utilize suspended, pending and denied claims as well as paid claims. Only paid claims are utilized in our calculation.""",No
Alabama,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid only,Administrative,39.4,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid only,Administrative,28.7,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,CHIP only,Administrative,43.0,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data."" State limited data to include children with a birth year of 2011. The specifications call for a 48 month look back if possible. The state looked back to 2018.",No
Alabama,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,CHIP only,Administrative,0.0,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data."" State limited data to include children with a birth year of 2011. The specifications call for a 48 month look back if possible. The state looked back to 2018.",No
Alabama,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid only,Administrative,19.3,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,CHIP only,Administrative,46.7,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,28.4,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,2.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,28.0,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data."" The measure allows for a Family Planning Only Services benefit to be included in the continuous enrollment criteria. We cannot identify this benefit, so it has been excluded. Only paid claims are utilized in our rule measure calculations. Suspended, pending, and denied claims are not included.",No
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,2.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data."" The measure allows for a Family Planning Only Services benefit to be included in the continuous enrollment criteria. We cannot identify this benefit, so it has been excluded. Only paid claims are utilized in our rule measure calculations. Suspended, pending, and denied claims are not included.",No
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,3.9,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,44.8,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,1.7,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,11.7,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,DS,34,5.7,3.8,8.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data."" State reported the following deviation: ""The measure allows for a Family Planning Only Services benefit to be included in the continuous enrollment criteria. We cannot identify this benefit, so it has been excluded.""",No
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,46.9,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data."" State reported the following deviation: ""The measure allows for a Family Planning Only Services benefit to be included in the continuous enrollment criteria. We cannot identify this benefit, so it has been excluded.""",No
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data."" State reported the following deviation: ""The measure allows for a Family Planning Only Services benefit to be included in the continuous enrollment criteria. We cannot identify this benefit, so it has been excluded.""",No
Alabama,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,DS,40,15.3,12.1,18.0,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data."" State reported the following deviation: ""The measure allows for a Family Planning Only Services benefit to be included in the continuous enrollment criteria. We cannot identify this benefit, so it has been excluded.""",No
Alabama,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,12.0,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Alabama,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,27.2,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Alabama,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid only,Administrative,71.1,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rate was audited or validated. This measure is included in our Alabama Coordinated Healthcare Networks (ACHN) quality incentive payment structure, and has received particular attention by the ACHN Networks to whom these financial incentive payments are made. This substantial rate increase compared to previous years is largely due to the increased effort on the part of the ACHN Network Entities.",Yes
Alabama,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,CHIP only,Administrative,68.5,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data."" The rates for ALL Kids PPC are always lower than our final rates for other lines of business because we do not perform medical record review (hybrid) for any ALL Kids measures.",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid only,Administrative,53.9,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid only,Administrative,47.9,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid only,Administrative,18.9,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid only,Administrative,47.0,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,CHIP only,Administrative,55.4,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,CHIP only,Administrative,44.6,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,CHIP only,Administrative,34.5,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,CHIP only,Administrative,49.9,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid only,Administrative,82.0,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid only,Administrative,29.9,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid only,Administrative,61.6,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid only,Administrative,21.5,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,CHIP only,Administrative,92.5,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data and supplemental data, such as lab data and immunization registry data, were received for this measure.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,CHIP only,Administrative,49.8,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data and supplemental data, such as lab data and immunization registry data, were received for this measure.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,CHIP only,Administrative,80.2,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data and supplemental data, such as lab data and immunization registry data, were received for this measure.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,CHIP only,Administrative,42.6,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data and supplemental data, such as lab data and immunization registry data, were received for this measure.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid only,Administrative,13.4,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Alabama Medicaid Policy stipulates that when chlamydia and gonorrhea are tested on the same date visit, the CPT Code 87801 is to be used. This code is not in the HEDIS Value Set and is not included for reporting. If this code were to be included, Alabama rates would more than double.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,CHIP only,Administrative,36.7,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid only,Administrative,34.7,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,CHIP only,Administrative,43.6,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP Claims Data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid only,Administrative,41.3,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid only,Administrative,78.6,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,CHIP only,Administrative,35.7,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,CHIP only,Administrative,76.9,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid only,Administrative,95.1,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid only,Administrative,23.0,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid only,Administrative,21.5,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,CHIP only,Administrative,75.8,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,CHIP only,Administrative,35.1,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,CHIP only,Administrative,32.6,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid only,Administrative,54.6,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid only,Administrative,64.8,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,CHIP only,Administrative,77.5,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alabama,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,CHIP only,Administrative,84.4,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""Separate CHIP claims data.""",No
Alaska,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,No
Alaska,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,26.8,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,44.5,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,8.0,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,16.8,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,74.0,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,51.6,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,45.0,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,28.4,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,27.3,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. This measure analyzes a small target population which results in fluctuation in the rates from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,52.0,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. This measure analyzes a small target population which results in fluctuation in the rate from year to year. There might be some undercount due to timely filing lag.,Yes
Alaska,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,20.5,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. There might be some underreporting due to timely filing lag.,Yes
Alaska,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,82.1,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag. CY2020 numbers adhered to events occurring in the reporting year only.,Yes
Alaska,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,74.5,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag. CY2020 numbers adhered to events occurring in the reporting year only.,Yes
Alaska,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,78.0,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag. CY2020 numbers adhered to events occurring in the reporting year only.,Yes
Alaska,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,42.6,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Alaska,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,54.3,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There might be some undercount due to timely filing lag.,Yes
Alaska,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,34.7,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There might be some undercount due to timely filing lag.,Yes
Alaska,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,15.3,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Alaska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,19.6,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,5.1,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,8.5,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,31.1,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,6.7,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,17.0,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,7.9,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Alaska,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,18.6,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Alaska,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,32.7,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,31.1,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,30.0,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,9.1,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,27.1,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,43.2,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. There might be some underreporting due to claims timely filing lag.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,3.5,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. Alaska Medicaid providers use code 96110 to bill for different types of developmental screening that might include the ASQ-SE and the M-CHAT, because AK Medicaid does not yet have policy to use a modifier to identify when one of the eight NQF endorsed standardized screening tools has been used. For this reason, the use of modifiers was taken into account in compiling this measure. Claims filed with procedure code modifiers other than 33 were not included.",Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,3.7,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There might be slight underreporting due to timely filing lag. This measure does not include the NDC codes associated with Rx vaccination. This likely lowered the numerator counts for this measure.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,10.3,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There might be slight underreporting due to timely filing lag. This measure does not include the NDC codes associated with Rx vaccination. This likely lowered the numerator counts for this measure.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,5.3,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,3.0,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,7.7,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,30.1,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Alaska,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,36.5,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. There is some underreporting due to timely filing lag.,Yes
Arizona,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,10.6,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (12 MCOs). Rate was audited or validated.,Yes
Arizona,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,72.2,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,83.0,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,72.0,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arizona,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,86.5,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arizona,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,58.9,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,70.3,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,54.4,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,41.0,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,40.3,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,67.4,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (12 MCOs). Rate was audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,27.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (15 MCOs). Rate was audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,76.9,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (15 MCOs). Rates were audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,69.6,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (15 MCOs). Rates were audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,73.0,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (15 MCOs). Rates were audited or validated.,Yes
Arizona,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,44.8,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (15 MCOs). Rate was audited or validated.,Yes
Arizona,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,57.3,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated.,Yes
Arizona,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,37.8,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated.,Yes
Arizona,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,18.2,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (12 MCOs). Rate was audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,17.8,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (15 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.8,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (15 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.8,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,32.7,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,1.3,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,11.9,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,8.8,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Arizona,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,21.1,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Arizona,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative & Hybrid,79.3,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rate was derived using both administrative and hybrid method data. Ten of 14 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,52.8,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,45.6,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,21.6,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,45.0,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative & Hybrid,80.6,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rates were derived using both administrative and hybrid method data. Nine of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,41.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rates were derived using both administrative and hybrid method data. Nine of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,61.3,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rates were derived using both administrative and hybrid method data. Nine of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,32.7,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rates were derived using both administrative and hybrid method data. Nine of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,45.0,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (15 MCOs). Rate was audited or validated.,Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative & Hybrid,39.8,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (12 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rate was derived using both administrative and hybrid method data. Six of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rate was audited or validated. The numerator includes a developmental screening CPT code that may include domain-specific conditions.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,40.7,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rates were derived using both administrative and hybrid method data. Nine of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,84.7,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rates were derived using both administrative and hybrid method data. Nine of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,63.9,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (12 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rates were derived using both administrative and hybrid method data. Eight of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,48.7,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (12 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rates were derived using both administrative and hybrid method data. Eight of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,44.7,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (12 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rates were derived using both administrative and hybrid method data. Eight of 12 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,56.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arizona,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,62.1,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (12 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arkansas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). State reported that rate excludes the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rate was audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and chemical dependency benefits.",No
Arkansas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,46.4,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and mental health benefits.",Yes
Arkansas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,62.9,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and mental health benefits.",Yes
Arkansas,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,45.4,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and mental health (inpatient and outpatient) benefits. Mental Health providers in MMIS are identified by Provider Type and Specialty Codes.",Yes
Arkansas,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,67.3,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and mental health (inpatient and outpatient) benefits. Mental Health providers in MMIS are identified by Provider Type and Specialty Codes.",Yes
Arkansas,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,24.3,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. State implemented the optional exclusions. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,31.3,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. State implemented the optional exclusions. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,69.0,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,54.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,53.5,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,77.2,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). State reported that the rate excludes the following populations: ""For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rate was audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical, mental health, and pharmacy benefits.",Yes
Arkansas,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,33.6,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that the rate excludes the following populations: ""For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. Last day of the month was used to calculate beneficiary months.",Yes
Arkansas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,73.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits during the measurement year and the year prior to the measurement year and pharmacy benefits during the measurement year.",Yes
Arkansas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,69.9,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits during the measurement year and the year prior to the measurement year and pharmacy benefits during the measurement year.",Yes
Arkansas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,71.8,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits during the measurement year and the year prior to the measurement year and pharmacy benefits during the measurement year.",Yes
Arkansas,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,49.4,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). State reported that the rate excludes the following populations: Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance aid category codes, non-Medicaid aid categories, and Arkansas Works benefit plan codes."" Rate was audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had dental benefits.",Yes
Arkansas,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,44.3,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had dental benefits.",Yes
Arkansas,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,28.8,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had dental benefits.",Yes
Arkansas,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,22.7,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). State reported that the rate excludes the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance aid category codes, non-Medicaid aid categories, and Arkansas Works benefit plan codes."" Rate was audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had dental benefits.",Yes
Arkansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,29.9,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. Calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. Calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.7,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,36.0,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,0.8,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,11.0,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.0,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Arkansas,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,26.6,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,48.9,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. To determine PCPs, state used applicable Medicaid provider types. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,44.5,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. To determine PCPs, state used applicable Medicaid provider types. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,13.7,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. To determine PCPs, state used applicable Medicaid provider types. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,41.8,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. To determine PCPs, state used applicable Medicaid provider types. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,82.7,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""claims and immunization registry data were used together to obtain immunization records for the entire eligible population)."" Rates were audited or validated. Did not implement the optional exclusion.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,32.0,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""claims and immunization registry data were used together to obtain immunization records for the entire eligible population)."" Rates were audited or validated. Did not implement the optional exclusion.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,56.4,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""claims and immunization registry data were used together to obtain immunization records for the entire eligible population)."" Rates were audited or validated. Did not implement the optional exclusion.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,23.5,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""claims and immunization registry data were used together to obtain immunization records for the entire eligible population)."" Rates were audited or validated. Did not implement the optional exclusion.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,47.2,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that the rate excludes the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. State implemented the optional exclusion. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,28.7,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated. Did not implement the optional exclusion because did not have codes that demonstrated ""the contraindicated immunization was rendered in its entirety.""",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,85.3,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated. Did not implement the optional exclusion because did not have codes that demonstrated ""the contraindicated immunization was rendered in its entirety.""",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,45.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. State reported the following deviations: ""Added newborn care CPT codes 99460 and 99463."" To identify PCPs, state used applicable Medicaid provider types. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
Arkansas,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,50.1,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" Rates were audited or validated. State reported the following deviations: ""Added newborn care CPT codes 99460 and 99463."" To identify PCPs, state used applicable Medicaid provider types. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
California,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,9.0,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,63.4,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,75.4,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,73.6,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,86.1,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,49.4,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,59.7,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,59.9,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,41.9,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,41.5,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,70.7,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,23.8,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,76.4,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,70.1,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,73.2,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,37.1,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (6 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,42.4,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,35.2,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,16.8,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,14.5,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.8,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,33.6,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.9,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,13.2,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,7.9,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
California,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.2,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
California,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative & Hybrid,75.2,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan for Kaiser North and South reported administratively."" Rate was derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rate is provisional. Rate was audited or validated.",Yes
California,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,58.9,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,55.3,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,37.1,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,53.6,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative & Hybrid,81.8,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Managed Care plan for Kaiser North and South as well as Blue Shield of California Promise Health Plan reported administratively."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates are provisional. Rates were audited or validated.",Yes
California,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,46.7,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Managed Care plan for Kaiser North and South as well as Blue Shield of California Promise Health Plan reported administratively."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates are provisional. Rates were audited or validated.",Yes
California,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,NR,47,61.5,56.4,67.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Managed Care plan for Kaiser North and South as well as Blue Shield of California Promise Health Plan reported administratively."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates are provisional. Rates were audited or validated.",No
California,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,34.8,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Managed Care plan for Kaiser North and South as well as Blue Shield of California Promise Health Plan reported administratively."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates are provisional. Rates were audited or validated.",Yes
California,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,59.5,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rate is provisional. Rate was audited or validated.",Yes
California,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,29.8,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,40.6,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (25 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data. Managed care plan for Kaiser North and South, Blue Cross of California Partnership Plan, Blue Shield of California Promise Health Plan, California Health & Wellness Plan (Region 1), CalViva Health (Kings County), Community Health Group Partnership Plan, and Health Net Community Solutions Inc. reported administratively."" Rate was derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rate is provisional. Rate was audited or validated.",Yes
California,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,NR,46,75.2,68.3,82.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (25 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data. Managed care plan for Kaiser North and South, Blue Cross of California Partnership Plan, Blue Shield of California Promise Health Plan, California Health & Wellness Plan (Region 1), CalViva Health (Kings County), Community Health Group Partnership Plan, and Health Net Community Solutions Inc. reported administratively."" Rate was derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rate is provisional. Rate was audited or validated.",No
California,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,86.4,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (25 MCOs). State reported that rates exclude the following populations: ""2.7% of Medicaid/CHIP populations who remained in FFS benefits for 11 out of 12 months."" The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan for Kaiser North and South reported administratively."" Denominator is the sample size; measure-eligible population is 2,213,580. Rates were audited or validated.",Yes
California,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,80.8,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (25 MCOs). State reported that rates exclude the following populations: ""2.7% of Medicaid/CHIP populations who remained in FFS benefits for 11 out of 12 months."" The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan for Kaiser North and South reported administratively."" Denominator is the sample size; measure-eligible population is 2,213,580. Rates were audited or validated.",Yes
California,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,80.2,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (25 MCOs). State reported that rates exclude the following populations: ""2.7% of Medicaid/CHIP populations who remained in FFS benefits for 11 out of 12 months."" The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan for Kaiser North and South reported administratively."" Denominator is the sample size; measure-eligible population is 2,213,580. Rates were audited or validated.",Yes
California,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,36.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,62.4,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Colorado,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid only,NR,NR,48,47.9,40.1,57.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Colorado,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid only,NR,NR,48,70.4,62.1,79.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Colorado,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,39.8,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,Yes
Colorado,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,56.2,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,Yes
Colorado,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid only,NR,NR,50,43.0,36.4,49.4,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Colorado,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid only,NR,NR,49,54.1,45.1,59.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Colorado,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,32.0,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,Yes
Colorado,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,43.8,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,Yes
Colorado,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid only,Administrative,49.3,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,26.3,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,25.0,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,CHIP only,Administrative,54.9,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,34.0,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,33.5,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid only,NR,NR,47,62.6,58.6,67.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Colorado,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,CHIP only,Administrative,59.4,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes managed care population (5 MCOs).,Yes
Colorado,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid only,NR,NR,46,31.9,36.2,26.0,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Colorado,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,CHIP only,Administrative,20.1,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes managed care population (5 MCOs).,Yes
Colorado,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid only,Administrative,56.9,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid only,Administrative,46.6,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid only,Administrative,51.5,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,CHIP only,Administrative,77.5,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,CHIP only,Administrative,66.2,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,CHIP only,Administrative,71.5,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid only,NR,NR,30,46.4,38.4,57.3,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Colorado,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid only,NR,NR,30,32.9,23.6,40.0,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Colorado,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,CHIP only,Administrative,24.5,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,Yes
Colorado,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,CHIP only,Administrative,14.3,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,24.6,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,5.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,28.6,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,6.0,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,4.2,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,36.9,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,2.4,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,17.9,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,0.0,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,38.0,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,0.0,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,22.0,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.0,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,20.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid only,Administrative,56.8,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and PCCM populations.,Yes
Colorado,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,CHIP only,Administrative,68.2,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes managed care population (5 MCOs). Administrative data sources are claims/encounters and vital records.,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid only,Administrative,49.8,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid only,Administrative,42.0,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid only,Administrative,18.2,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid only,Administrative,41.7,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,CHIP only,Administrative,51.7,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,CHIP only,Administrative,43.7,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,CHIP only,Administrative,18.9,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,CHIP only,Administrative,44.3,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid only,Administrative,80.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid only,Administrative,54.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid only,Administrative,61.1,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid only,Administrative,39.7,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,CHIP only,Administrative,79.0,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs). Administrative data sources are claims/encounters and state immunization registry.,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,CHIP only,Administrative,56.0,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs). Administrative data sources are claims/encounters and state immunization registry.,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,CHIP only,Administrative,63.0,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs). Administrative data sources are claims/encounters and state immunization registry.,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,CHIP only,Administrative,43.1,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs). Administrative data sources are claims/encounters and state immunization registry.,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid only,Administrative,47.1,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,CHIP only,Administrative,60.5,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes managed care population (5 MCOs).,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid only,NR,NR,37,34.7,27.3,51.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,CHIP only,Administrative,57.2,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes managed care population (5 MCOs).,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid only,Administrative,35.2,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid only,Administrative,69.0,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,CHIP only,Administrative,38.3,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs). Administrative data sources are claims/encounters and state immunization registry.,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,CHIP only,Administrative,70.0,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs). Administrative data sources are claims/encounters and state immunization registry.,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid only,Administrative,21.0,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid only,Administrative,19.4,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid only,Administrative,13.4,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,CHIP only,Administrative,43.2,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,CHIP only,Administrative,45.0,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,CHIP only,Administrative,41.4,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid only,Administrative,64.6,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid only,Administrative,59.2,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
Colorado,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,CHIP only,Administrative,51.6,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Colorado,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,CHIP only,Administrative,58.4,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (5 MCOs).,No
Connecticut,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. Rate was audited or validated.,No
Connecticut,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,65.8,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,79.7,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,57.4,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,78.7,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,43.7,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,52.9,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,50.5,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,37.0,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,34.0,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,81.0,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. Rate was audited or validated.,Yes
Connecticut,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,34.3,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. Rate was audited or validated.,Yes
Connecticut,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,66.1,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,64.6,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,65.4,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,51.4,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,58.9,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,39.7,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,26.6,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,26.1,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.9,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,14.1,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,44.2,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,9.1,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,18.2,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,10.2,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Connecticut,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,27.2,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Connecticut,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,92.6,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. Denominator is the sample size; measure-eligible population is 11,407. Rate was audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,73.3,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,70.8,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,40.9,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,66.6,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,87.6,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Denominator is the sample size; measure-eligible population is 15,306. Rates were audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,71.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Denominator is the sample size; measure-eligible population is 15,306. Rates were audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,75.7,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Denominator is the sample size; measure-eligible population is 15,306. Rates were audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,59.3,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Denominator is the sample size; measure-eligible population is 15,306. Rates were audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,62.5,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. Rate was audited or validated.,Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,65.0,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,37.7,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Denominator is the sample size; measure-eligible population is 17,654. Rates were audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,86.6,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Denominator is the sample size; measure-eligible population is 17,654. Rates were audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,85.3,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Denominator is the sample size; measure-eligible population is 225,264. Rates were audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,78.9,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Denominator is the sample size; measure-eligible population is 225,264. Rates were audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,73.9,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Denominator is the sample size; measure-eligible population is 225,264. Rates were audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,77.4,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,82.3,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Delaware,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,33.5,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-for-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,42.2,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-for-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,61.5,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,53.9,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,49.9,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,54.4,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,33.3,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-for-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,69.6,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,57.2,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,63.3,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,23.7,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.4,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,16.3,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,47.8,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,7.0,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,15.3,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.1,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Delaware,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,24.8,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Delaware,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,91.4,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 3,387. Rate was audited or validated. One MCO reduced its sample size to 270 based on the prior year's medical record review results as allowed by the NCQA HEDIS measurement year 2021 General Guidelines.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,65.7,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,58.8,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,28.8,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,57.5,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,86.5,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 5,053. Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,52.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 5,053. Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,70.5,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 5,053. Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,38.9,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 5,053. Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,59.7,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Hybrid,82.5,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 11,784. Rate was audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,48.0,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 5,254. Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,73.9,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 5,254. Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,81.1,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 59,017. Rates were audited or validated. One MCO reduced its sample size to 342 based on prior year medical record review results as allowed by the NCQA HEDIS measurement year 2021 General Guidelines.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,74.3,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 59,017. Rates were audited or validated. One MCO reduced its sample size to 342 based on prior year medical record review results as allowed by the NCQA HEDIS measurement year 2021 General Guidelines.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,72.2,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 59,017. Rates were audited or validated. One MCO reduced its sample size to 342 based on prior year medical record review results as allowed by the NCQA HEDIS measurement year 2021 General Guidelines.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,61.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,74.1,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Dist. of Col.,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,49.0,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,68.8,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,37.5,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,56.8,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,44.0,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,33.2,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,29.7,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,27.5,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,39.8,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,73.8,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,60.4,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,67.6,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,55.3,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only.""",Yes
Dist. of Col.,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,42.1,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only.""",Yes
Dist. of Col.,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,19.2,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.6,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,8.1,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,35.5,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",No
Dist. of Col.,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,14.7,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,13.5,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Dist. of Col.,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,28.5,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Dist. of Col.,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,81.4,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 2,557. Rate was audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,56.8,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,55.4,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,31.7,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,52.6,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,71.6,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 2,674.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,31.7,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 2,674.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,42.6,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 2,674.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,19.4,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 2,674.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,71.9,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,22.8,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rate was audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,40.7,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 2,607.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,68.3,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 2,607.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,73.1,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 40,326. Rates were audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,72.2,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 40,326. Rates were audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,69.9,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 40,326. Rates were audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,28.2,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,52.1,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Florida,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,3.6,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,38.0,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,54.6,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,34.3,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,56.4,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,43.9,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data reported by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,59.7,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data reported by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,51.3,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,36.6,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,34.7,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,60.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated.",Yes
Florida,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,41.5,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data reported by the health plans."" Rate was audited or validated.",Yes
Florida,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,81.5,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,72.8,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,77.6,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,35.6,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated.",Yes
Florida,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,38.4,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,25.0,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,22.1,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated.",Yes
Florida,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,16.9,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,1.7,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,2.0,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,30.9,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,0.7,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,8.0,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,10.6,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Florida,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,27.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Florida,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative & Hybrid,76.3,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was derived using both administrative and hybrid method data. Fee-For-Service, managed care, and Children's Medical Services Health Plan (CMSHP) used the hybrid methodology. Medikids is not included because the age group is not applicable for this measure. Florida Healthy Kids used both hybrid and administrative methodology. The measure-eligible population is 74,394. Rate was audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,62.6,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,53.9,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,27.0,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,54.5,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative & Hybrid,NR,46,82.0,78.4,84.9,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were derived using both administrative and hybrid method data. Fee-For-Service, MediKids, and Children's Medical Services Health Plan (CMSHP) used hybrid methodology. Florida Healthy Kids is not included because the age group is not applicable for this measure. Eleven Medicaid Managed Care plans used the hybrid methodology and 1 plan reported using the administrative methodology. The measure-eligible population is 125,102. Rates were audited or validated. Medicaid managed care plans were only required to collect and submit rates for Combination 3 and Combination 10.",No
Florida,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,NR,46,45.7,37.1,52.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were derived using both administrative and hybrid method data. Fee-For-Service, MediKids, and Children's Medical Services Health Plan (CMSHP) used hybrid methodology. Florida Healthy Kids is not included because the age group is not applicable for this measure. Eleven Medicaid Managed Care plans used the hybrid methodology and 1 plan reported using the administrative methodology. The measure-eligible population is 125,102. Rates were audited or validated. Medicaid managed care plans were only required to collect and submit rates for Combination 3 and Combination 10.",No
Florida,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,68.8,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were derived using both administrative and hybrid method data. Fee-For-Service, MediKids, and Children's Medical Services Health Plan (CMSHP) used hybrid methodology. Florida Healthy Kids is not included because the age group is not applicable for this measure. Eleven Medicaid Managed Care plans used the hybrid methodology and 1 plan reported using the administrative methodology. The measure-eligible population is 125,102. Rates were audited or validated. Medicaid managed care plans were only required to collect and submit rates for Combination 3 and Combination 10.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,31.6,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (12 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were derived using both administrative and hybrid method data. Fee-For-Service, MediKids, and Children's Medical Services Health Plan (CMSHP) used hybrid methodology. Florida Healthy Kids is not included because the age group is not applicable for this measure. Eleven Medicaid Managed Care plans used the hybrid methodology and 1 plan reported using the administrative methodology. The measure-eligible population is 125,102. Rates were audited or validated. Medicaid managed care plans were only required to collect and submit rates for Combination 3 and Combination 10.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,58.3,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Hybrid,27.9,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (12 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Denominator is the sample size; measure-eligible population is 334,302. Rate was audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,40.3,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were derived using both administrative and hybrid method data. Fee-For-Service, Children's Medical Services Health Plan (CMSHP), and Florida Healthy Kids used the hybrid methodology. MediKids is not included because the age group is not applicable for this measure. Ten Medicaid Managed Care plans used the hybrid methodology and 4 plans used the administrative methodology. The measure-eligible population is 120,652. Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,73.4,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were derived using both administrative and hybrid method data. Fee-For-Service, Children's Medical Services Health Plan (CMSHP), and Florida Healthy Kids used the hybrid methodology. MediKids is not included because the age group is not applicable for this measure. Ten Medicaid Managed Care plans used the hybrid methodology and 4 plans used the administrative methodology. The measure-eligible population is 120,652. Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,83.9,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: "" Data submitted by the health plans."" Rates were derived using both administrative and hybrid method data. Fee-For-Service, MediKids, Children's Medical Services Health Plan (CMSHP), and Florida Health Kids used the hybrid methodology. Thirteen Medicaid Managed Care plans used the hybrid methodology and 1 plan used the administrative methodology for BMI but used hybrid for Nutrition and Physical Activity. The measure-eligible population is 1,384,692. Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,79.9,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: "" Data submitted by the health plans."" Rates were derived using both administrative and hybrid method data. Fee-For-Service, MediKids, Children's Medical Services Health Plan (CMSHP), and Florida Health Kids used the hybrid methodology. Thirteen Medicaid Managed Care plans used the hybrid methodology and 1 plan used the administrative methodology for BMI but used hybrid for Nutrition and Physical Activity. The measure-eligible population is 1,384,692. Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,77.4,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: "" Data submitted by the health plans."" Rates were derived using both administrative and hybrid method data. Fee-For-Service, MediKids, Children's Medical Services Health Plan (CMSHP), and Florida Health Kids used the hybrid methodology. Thirteen Medicaid Managed Care plans used the hybrid methodology and 1 plan used the administrative methodology for BMI but used hybrid for Nutrition and Physical Activity. The measure-eligible population is 1,384,692. Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,59.4,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (11 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,72.1,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (11 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,49.3,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,72.0,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,41.7,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,59.5,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,48.8,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,30.5,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,27.3,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,60.8,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rate was audited or validated.",Yes
Georgia,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,32.5,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the CMOs' audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rate was audited or validated.",Yes
Georgia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,82.3,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,73.6,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,78.2,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,12.9,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Georgia,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,27.0,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Georgia,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,77.9,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 51,994. Rate was audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,54.5,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,49.0,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,23.7,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,49.1,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,82.0,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 71,246. Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,27.3,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 71,246. Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,62.5,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 71,246. Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,21.7,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 71,246. Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,59.4,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rate was audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Hybrid,51.3,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 195,933. Rate was audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,33.1,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 67,052. Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,82.5,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 67,052. Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,80.3,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 752,543. Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,72.1,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 752,543. Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,69.1,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,233; measure-eligible population is 752,543. Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,59.5,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rates were audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,67.6,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,44.9,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,66.2,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,46.2,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,61.6,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,41.1,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,22.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,21.7,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,61.5,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,19.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,77.3,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,68.9,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,73.1,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,18.9,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.7,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,5.6,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,44.1,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.8,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,25.0,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.5,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Hawaii,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.5,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Hawaii,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,83.8,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Denominator is the sample size; measure-eligible population is 6,028.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,51.6,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,50.6,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,21.6,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,46.0,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative & Hybrid,74.5,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were derived using both administrative and hybrid method data. One health plan used administrative method and four health plans used hybrid method. The measure-eligible population is 7,909.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,55.0,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were derived using both administrative and hybrid method data. One health plan used administrative method and four health plans used hybrid method. The measure-eligible population is 7,909.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,55.9,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were derived using both administrative and hybrid method data. One health plan used administrative method and four health plans used hybrid method. The measure-eligible population is 7,909.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,38.3,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were derived using both administrative and hybrid method data. One health plan used administrative method and four health plans used hybrid method. The measure-eligible population is 7,909.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,44.5,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative & Hybrid,24.4,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Health Plans."" Rate was derived using both administrative and hybrid method data. One health plan used administrative method and four health plans used hybrid method. The measure-eligible population is 22,957.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,40.8,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were derived using both administrative and hybrid method data. One health plan used administrative method and four health plans used hybrid method. The measure-eligible population is 7,939.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,66.9,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were derived using both administrative and hybrid method data. One health plan used administrative method and four health plans used hybrid method. The measure-eligible population is 7,939.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,80.9,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Denominator is the sample size; measure-eligible population is 80,847.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,77.9,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Denominator is the sample size; measure-eligible population is 80,847.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,75.5,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Denominator is the sample size; measure-eligible population is 80,847.",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,63.7,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,68.6,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Idaho,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,21.4,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,42.1,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,69.8,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,41.8,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,45.1,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,44.2,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,17.4,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,16.5,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,64.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,24.8,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,77.0,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,65.5,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,70.0,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,49.8,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,23.3,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional. Data do not include taxonomy codes from encounters and are mapped to specialty codes.,Yes
Idaho,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,27.1,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,5.4,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,34,5.7,3.8,8.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,No
Idaho,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,43.2,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,No
Idaho,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,20.2,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,7.9,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Idaho,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,17.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Idaho,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,51.0,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,40.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,18.7,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,42.6,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,27.3,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Illinois,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,10.4,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Illinois,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,24.6,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Indiana,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,9.0,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Rate was audited or validated.,Yes
Indiana,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,51.3,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,68.6,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,48.1,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.,Yes
Indiana,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,72.1,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.,Yes
Indiana,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,43.0,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.,Yes
Indiana,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,53.9,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.,Yes
Indiana,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,45.8,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,26.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,25.2,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,61.4,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Rate was audited or validated. Results reported are from each managed care entity's HEDIS auditor.,Yes
Indiana,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,36.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Rate was audited or validated.,Yes
Indiana,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,78.5,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,68.2,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,73.2,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,40.7,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs).,Yes
Indiana,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,47.3,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,40.0,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,15.5,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs).,Yes
Indiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,11.9,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,1.8,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,5.2,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,39.4,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.2,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,15.3,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,10.1,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Indiana,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,22.4,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Indiana,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,82.3,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 1,538. Rate was audited or validated.",Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,55.8,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,50.5,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,26.6,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,50.5,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,80.3,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 1,644. Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.",Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,48.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 1,644. Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.",Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,56.4,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 1,644. Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.",Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,29.9,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 1,644. Rates were audited or validated. Results reported are from each managed care entity's HEDIS auditor.",Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,47.9,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Rate was audited or validated.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,25.0,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Rate was audited or validated.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,34.5,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 1,644. Rates were audited or validated.",Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,81.5,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 1,644. Rates were audited or validated.",Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,59.1,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,58.4,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,51.8,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,58.1,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Indiana,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,64.1,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Rates were audited or validated.,Yes
Iowa,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,50.0,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,52.1,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,74.4,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,52.0,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,70.8,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,49.4,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,56.7,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,46.4,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,23.4,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,22.4,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,62.7,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,31.3,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,61.2,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,53.2,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,57.0,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,44.5,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,30.2,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,23.6,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,18.6,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,29.9,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.4,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,34,5.7,3.8,8.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,No
Iowa,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,39.7,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,No
Iowa,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,12.5,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,8.0,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Iowa,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.2,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Iowa,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,75.9,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,60.7,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,58.8,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,38.9,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,56.7,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,69.3,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,40.0,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,33.3,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,18.7,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,36.8,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,31.8,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,58.4,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,65.1,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Kansas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,21.7,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs). Rate is provisional.,Yes
Kansas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,67.7,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs). Rates are provisional. One MCO did not provide data.,Yes
Kansas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,73.9,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs). Rates are provisional. One MCO did not provide data.,Yes
Kansas,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,59.0,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,79.3,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,45.1,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,56.9,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,59.8,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,47.2,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,45.8,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,79.5,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate is provisional.,Yes
Kansas,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,36.2,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate is provisional.,Yes
Kansas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,76.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,69.3,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,72.7,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,18.2,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs). Rate is provisional. One MCO did not provide data.,Yes
Kansas,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,51.5,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,32.8,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,24.7,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs). Rate is provisional. One MCO did not provide data.,Yes
Kansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,29.6,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional.,Yes
Kansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.5,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional.,Yes
Kansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.5,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,39.3,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,1.5,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,16.0,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates are provisional.,Yes
Kansas,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.5,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Kansas,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Kansas,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,78.4,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). Sample size is 4,740; measure-eligible population is 11,373. Rate is provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,53.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional.,Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,49.0,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional.,Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,21.5,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional.,Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,47.6,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional.,Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,83.5,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 15,330. Rates are provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,44.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 15,330. Rates are provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,64.8,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 15,330. Rates are provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,35.6,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 15,330. Rates are provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative & Electronic Health Records,40.1,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate is provisional.,Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,34.5,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate is provisional.,Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,34.9,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Sample size is 11,734; measure-eligible population is 14,859. Rates are provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,79.6,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Sample size is 11,734; measure-eligible population is 14,859. Rates are provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,62.4,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data."" Sample size is 21,815; measure-eligible population is 102,740. Rates are provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,60.3,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data."" Sample size is 21,815; measure-eligible population is 102,740. Rates are provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,56.3,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data."" Sample size is 21,815; measure-eligible population is 102,740. Rates are provisional.",Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,56.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional.,Yes
Kansas,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,60.5,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,4.9,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate was audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,54.7,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,71.6,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,47.6,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,72.7,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,42.8,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,54.1,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,48.9,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,31.8,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,30.0,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,62.5,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate was audited or validated.,Yes
Kentucky,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,78.6,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,68.5,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,73.1,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.1,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Kentucky,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,27.6,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Kentucky,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,84.2,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rate was audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,52.1,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,43.4,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,20.2,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,44.2,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,84.4,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,37.1,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,64.1,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,28.1,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,48.0,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate was audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,75.6,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,59.0,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,56.8,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,59.3,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,66.7,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,No
Louisiana,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,39.2,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,58.1,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,36.4,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,60.0,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,35.4,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,50.9,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,53.4,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,28.6,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,27.8,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,67.2,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,43.1,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,80.6,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,75.6,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,78.1,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,43.5,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,51.0,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,35.9,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,14.6,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,30.0,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.1,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,5.5,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,45.1,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.6,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,12.8,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,13.1,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Louisiana,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,29.4,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Louisiana,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,81.5,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 31,813. Rate was audited or validated.",Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,53.3,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,50.5,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,26.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,47.5,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,81.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,29.5,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,60.0,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,22.1,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,60.3,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,23.1,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,41.5,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,85.0,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,71.0,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 446,472. Rates were audited or validated.",Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,61.3,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 446,472. Rates were audited or validated.",Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,54.5,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 446,472. Rates were audited or validated.",Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,54.6,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,61.4,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Maine,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",No
Maine,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,86.1,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,91.8,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,42.7,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,66.3,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,58.1,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,64.4,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,58.4,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,46.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,45.6,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,62.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,27.2,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,NR,47,77.3,73.2,80.7,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",No
Maine,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,NR,47,68.8,64.8,72.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",No
Maine,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,84.5,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,37.5,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,31.4,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,7.2,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,44.7,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.9,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,19.3,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.5,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Maine,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.4,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Maine,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,81.5,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims."" Administrative data sources are claims/encounters and vital records.",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,58.6,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,52.1,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,30.4,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,52.3,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,66.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that: ""Because we do not have access to Maine Immunization Information System (ImmPact) data, measure results may be inaccurate. Also, results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,45.0,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that: ""Because we do not have access to Maine Immunization Information System (ImmPact) data, measure results may be inaccurate. Also, results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,12.5,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that: ""Because we do not have access to Maine Immunization Information System (ImmPact) data, measure results may be inaccurate. Also, results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,7.9,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that: ""Because we do not have access to Maine Immunization Information System (ImmPact) data, measure results may be inaccurate. Also, results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,39.1,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,34.8,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,20.5,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that: ""Because we do not have access to Maine Immunization Information System (ImmPact) data, measure results may be inaccurate. Also, results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,53.6,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that: ""Because we do not have access to Maine Immunization Information System (ImmPact) data, measure results may be inaccurate. Also, results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,9.2,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state noted: ""Because the code set used for the measure may not be widely used in claims, measure results may be inaccurate. Also, results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,7.5,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state noted: ""Because the code set used for the measure may not be widely used in claims, measure results may be inaccurate. Also, results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,3.1,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state noted: ""Because the code set used for the measure may not be widely used in claims, measure results may be inaccurate. Also, results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,61.0,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maine,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,72.0,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviation: ""Results include only paid claims, deviating from measure specifications which call for inclusion of all paid, suspended, pending, and denied claims.""",Yes
Maryland,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,No
Maryland,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,46.0,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,64.4,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,53.9,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,83.1,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,58.6,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,16.5,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,62.3,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,53.4,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,50.3,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,66.7,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,Yes
Maryland,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,CHIP only,Administrative,24.4,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes managed care population (9 MCOs). Rate was audited or validated.,Yes
Maryland,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,77.6,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Maryland,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,73.8,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Maryland,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,75.7,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Maryland,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,49.6,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,Yes
Maryland,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,24.3,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). State reported the following deviation: ""Maryland has a stand-alone dental plan that reimburses only for services rendered by or under the supervision of the dentist, therefore the Department considers and reports all services as ""dental"" services.""",Yes
Maryland,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,10.7,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Maryland,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,27.5,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Maryland,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,88.3,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (9 MCOs). Denominator is the sample size; measure-eligible population is 21,863. Rate was audited or validated.",Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,65.9,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,60.3,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,38.2,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,59.4,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,NR,46,82.0,78.4,84.9,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). Sample size is 3,693; measure-eligible population is 30,476. Rates were audited or validated.",No
Maryland,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,NR,46,45.7,37.1,52.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). Sample size is 3,693; measure-eligible population is 30,476. Rates were audited or validated.",No
Maryland,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,68.4,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). Sample size is 3,693; measure-eligible population is 30,476. Rates were audited or validated.",Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,41.6,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). Sample size is 3,693; measure-eligible population is 30,476. Rates were audited or validated.",Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,58.9,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (9 MCOs). Rate was audited or validated.,Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,41.3,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). Denominator is the sample size; measure-eligible population is not available. Rates were audited or validated. State reported the following deviations: ""Kaiser used Administrative data; MDH requested MetaStar remove Kaiser results from the state's rate.""",Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,80.8,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). Denominator is the sample size; measure-eligible population is not available. Rates were audited or validated. State reported the following deviations: ""Kaiser used Administrative data; MDH requested MetaStar remove Kaiser results from the state's rate.""",Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,76.0,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). Denominator is the sample size; measure-eligible population is 388,424. Rates were audited or validated.",Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,73.3,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). Denominator is the sample size; measure-eligible population is 388,424. Rates were audited or validated.",Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,69.7,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). Denominator is the sample size; measure-eligible population is 388,424. Rates were audited or validated.",Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,56.3,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Maryland,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,74.6,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,16.3,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs). Rate was audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,88.8,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,91.9,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,60.3,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,82.1,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,44.5,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,54.7,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,57.5,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,43.9,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,42.0,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,76.0,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs). Rate was audited or validated.,Yes
Massachusetts,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,29.4,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs). Rate was audited or validated.,Yes
Massachusetts,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,65.5,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,61.9,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,63.7,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,51.3,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,71.5,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,62.4,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,44.6,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,9.2,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care maangement (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,1.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care maangement (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,9.9,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,47.2,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,5.8,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,22.8,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.3,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Massachusetts,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,25.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Massachusetts,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,88.6,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rate was audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,73.5,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,69.4,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,44.7,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,67.1,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,89.7,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,68.9,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,74.7,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,52.9,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,66.7,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs). Rate was audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,72.5,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,46.8,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,85.2,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,81.7,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,79.6,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,74.7,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,73.6,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,80.7,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Michigan,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,61.4,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse/Contains copy of MMIS data.""",Yes
Michigan,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,83.3,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse/Contains copy of MMIS data.""",Yes
Michigan,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,40.3,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims review only."" Rates were audited or validated.",Yes
Michigan,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,51.2,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims review only."" Rates were audited or validated.",Yes
Michigan,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,34.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims review only."" Rate was audited or validated.",Yes
Michigan,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,73.2,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims review only."" Rates were audited or validated.",Yes
Michigan,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,64.8,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims review only."" Rates were audited or validated.",Yes
Michigan,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,68.6,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims review only."" Rates were audited or validated.",Yes
Michigan,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,25.4,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse - Contains a copy of MMIS data."" State reported the following deviations: ""The specifications state that paid, suspended/pending and denied claims should all be included. The rates reported do not include suspended/pending claims as these are a very tiny fraction of all claims and would be very difficult to include.""",Yes
Michigan,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.8,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse - Contains a copy of MMIS data."" State reported the following deviations: ""The specifications state that paid, suspended/pending and denied claims should all be included. The rates reported do not include suspended/pending claims as these are a very tiny fraction of all claims and would be very difficult to include.""",Yes
Michigan,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,5.7,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse - Contains a copy of MMIS data."" State reported the following deviations: ""The specifications state that paid, suspended/pending and denied claims should all be included. The rates reported do not include suspended/pending claims as these are a very tiny fraction of all claims and would be very difficult to include.""",Yes
Michigan,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,35.1,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse - Contains a copy of MMIS data."" State reported the following deviations: ""The specifications state that paid, suspended/pending and denied claims should all be included. The rates reported do not include suspended/pending claims as these are a very tiny fraction of all claims and would be very difficult to include.""",Yes
Michigan,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,1.5,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse - Contains a copy of MMIS data."" State reported the following deviations: ""The specifications state that paid, suspended/pending and denied claims should all be included. The rates reported do not include suspended/pending claims as these are a very tiny fraction of all claims and would be very difficult to include.""",Yes
Michigan,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,9.7,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse - Contains a copy of MMIS data."" State reported the following deviations: ""The specifications state that paid, suspended/pending and denied claims should all be included. The rates reported do not include suspended/pending claims as these are a very tiny fraction of all claims and would be very difficult to include.""",Yes
Michigan,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.6,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Michigan,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,27.0,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Michigan,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,79.9,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Denominator is the sample size; measure-eligible population is 35,163. Rate was audited or validated. The numerator and denominator represent the sum of the numerators and denominators from all Medicaid Health Plans (MHPs). Since certain MHPs used the hybrid method (and a sample) to report their rates, the Medicaid statewide rate is weighted based on each MHPs eligible population. Therefore, dividing the numerator and denominator will not yield the reported statewide rate.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,58.1,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims data only."" Rates were audited or validated.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,49.9,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims data only."" Rates were audited or validated.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,29.0,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims data only."" Rates were audited or validated.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,50.5,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims data only."" Rates were audited or validated.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,77.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Sample size is not available; measure-eligible population is 46,196. Rates were audited or validated. The numerator and denominator represent the sum of the numerators and denominators from all Medicaid Health Plans (MHPs). Since certain MHPs used the hybrid method (and a sample) to report their rates, the Medicaid statewide rate is weighted based on each MHPs eligible population for each measure. Therefore, dividing the numerator and denominator will not yield the reported statewide rate.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,38.6,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Sample size is not available; measure-eligible population is 46,196. Rates were audited or validated. The numerator and denominator represent the sum of the numerators and denominators from all Medicaid Health Plans (MHPs). Since certain MHPs used the hybrid method (and a sample) to report their rates, the Medicaid statewide rate is weighted based on each MHPs eligible population for each measure. Therefore, dividing the numerator and denominator will not yield the reported statewide rate.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,55.5,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Sample size is not available; measure-eligible population is 46,196. Rates were audited or validated. The numerator and denominator represent the sum of the numerators and denominators from all Medicaid Health Plans (MHPs). Since certain MHPs used the hybrid method (and a sample) to report their rates, the Medicaid statewide rate is weighted based on each MHPs eligible population for each measure. Therefore, dividing the numerator and denominator will not yield the reported statewide rate.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,28.3,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Sample size is not available; measure-eligible population is 46,196. Rates were audited or validated. The numerator and denominator represent the sum of the numerators and denominators from all Medicaid Health Plans (MHPs). Since certain MHPs used the hybrid method (and a sample) to report their rates, the Medicaid statewide rate is weighted based on each MHPs eligible population for each measure. Therefore, dividing the numerator and denominator will not yield the reported statewide rate.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,58.1,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims data."" Rate was audited or validated.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,27.3,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Health Plan Encounter Data from the State of Michigan Data Warehouse."" State moved from a custom query to standardized software (Symmetry) to calculate the results.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,34.2,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Sample size is not available; measure-eligible population is 41,372. Rates were audited or validated. The numerator and denominator represent the sum of the numerators and denominators from all Medicaid Health Plans (MHPs). Since certain MHPs used the hybrid method (and a sample) to report their rates, the Medicaid statewide rate is weighted based on each MHPs eligible population for each measure. Therefore, dividing the numerator and denominator will not yield the reported statewide rate.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,76.9,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Sample size is not available; measure-eligible population is 41,372. Rates were audited or validated. The numerator and denominator represent the sum of the numerators and denominators from all Medicaid Health Plans (MHPs). Since certain MHPs used the hybrid method (and a sample) to report their rates, the Medicaid statewide rate is weighted based on each MHPs eligible population for each measure. Therefore, dividing the numerator and denominator will not yield the reported statewide rate.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,79.7,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Denominator is the sample size; measure-eligible population is 470,985. Rates were audited or validated.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,72.0,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Denominator is the sample size; measure-eligible population is 470,985. Rates were audited or validated.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,70.5,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims and medical records review."" Denominator is the sample size; measure-eligible population is 470,985. Rates were audited or validated.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,58.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims review only."" Rates were audited or validated.",Yes
Michigan,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,61.0,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (10 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Claims review only."" Rates were audited or validated.",Yes
Minnesota,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,24.7,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,70.2,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,82.7,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,51.7,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,77.3,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,36.4,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,44.3,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,51.7,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,34.8,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,33.7,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,68.7,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,29.3,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,70.3,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,65.0,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,67.3,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,43.5,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,31.1,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,26.4,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.8,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.8,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,37.9,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,1.7,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,16.9,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,8.5,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Minnesota,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,25.8,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Minnesota,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,59.0,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,52.0,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,44.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,22.0,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,44.4,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,74.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Administrative data sources are claims/encounters and state immunization registry. Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,52.8,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Administrative data sources are claims/encounters and state immunization registry. Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,55.4,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Administrative data sources are claims/encounters and state immunization registry. Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,37.3,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Administrative data sources are claims/encounters and state immunization registry. Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,44.3,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,49.6,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Data source includes paid claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,32.2,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Administrative data sources are claims/encounters and state immunization registry. Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,75.1,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Administrative data sources are claims/encounters and state immunization registry. Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,44.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Minnesota,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,56.2,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Data source includes paid and denied claims only.,Yes
Mississippi,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,34.7,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,53.6,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,38.7,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,64.3,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,43.4,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care). MS Medicaid attributes the lower rate to the impacts of the COVID-19 Public Health Emergency resulting in rates that are not comparable to previous years.",Yes
Mississippi,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,56.7,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care). MS Medicaid attributes the lower rate to the impacts of the COVID-19 Public Health Emergency resulting in rates that are not comparable to previous years.",Yes
Mississippi,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,63.1,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,81.9,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,72.5,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,76.8,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,14.4,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Mississippi,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,30.9,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,43.4,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,37.3,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,19.6,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,39.4,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,89.5,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. Denominator is the sample size; measure-eligible population is 124,959. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care). MS Medicaid attributes the lower rate to the impacts of the COVID-19 Public Health Emergency resulting in rates that are not comparable to previous years.",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,32.3,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. Denominator is the sample size; measure-eligible population is 124,959. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care). MS Medicaid attributes the lower rate to the impacts of the COVID-19 Public Health Emergency resulting in rates that are not comparable to previous years.",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,69.7,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. Denominator is the sample size; measure-eligible population is 124,959. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care). MS Medicaid attributes the lower rate to the impacts of the COVID-19 Public Health Emergency resulting in rates that are not comparable to previous years.",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,25.6,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. Denominator is the sample size; measure-eligible population is 124,959. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care). MS Medicaid attributes the lower rate to the impacts of the COVID-19 Public Health Emergency resulting in rates that are not comparable to previous years.",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,46.2,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,55.4,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,55.4,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,59.1,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 195,189. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,47.5,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 195,189. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,44.6,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 195,189. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,56.2,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,62.8,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Missouri,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,9.1,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that rate excludes the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rate was audited or validated.",Yes
Missouri,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,39.6,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated.",Yes
Missouri,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,58.9,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated.",Yes
Missouri,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,34.1,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated.",Yes
Missouri,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,57.3,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated.",Yes
Missouri,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,31.2,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,33.3,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,55.6,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.,Yes
Missouri,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,35.3,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.,Yes
Missouri,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,34.5,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.,Yes
Missouri,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,59.5,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.,Yes
Missouri,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,44.8,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rate was audited or validated.",Yes
Missouri,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,62.5,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated.",Yes
Missouri,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,57.8,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated.",Yes
Missouri,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,60.1,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated.",Yes
Missouri,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,32.0,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This will include some members ages 18-20.,Yes
Missouri,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,49.0,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.,Yes
Missouri,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,33.0,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.,Yes
Missouri,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,10.5,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This will include some members ages 18-20.,Yes
Missouri,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,30.7,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical. Additionally, Missouri added the Adult Expansion Group in July 2021. This will include some members ages 18-20.",Yes
Missouri,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.0,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical. Additionally, Missouri added the Adult Expansion Group in July 2021. This will include some members ages 18-20.",Yes
Missouri,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,6.5,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This will include some members ages 18-20.,Yes
Missouri,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,45.0,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This will include some members ages 18-20.,Yes
Missouri,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.7,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This will include some members ages 18-20.,Yes
Missouri,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,15.3,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This will include some members ages 18-20.,Yes
Missouri,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.2,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Missouri,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,22.2,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Missouri,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,88.9,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 26,005. Rate was audited or validated. While the rates for this year are comparable to last year, the numerators and denominators are lower due to NCQA permitting MCOs to use a smaller sample size under certain conditions for this measure. Two of our three MCOs opted to do this. Additionally, Missouri added the Adult Expansion Group in July 2021. This will include some members ages 18-20.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,47.3,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,43.0,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,20.2,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,42.6,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,75.7,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 31,464. Rates were audited or validated. The pandemic is reported to have had a negative impact on immunizations, as reflected in our rates.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,38.1,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 31,464. Rates were audited or validated. The pandemic is reported to have had a negative impact on immunizations, as reflected in our rates.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,55.4,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 31,464. Rates were audited or validated. The pandemic is reported to have had a negative impact on immunizations, as reflected in our rates.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,27.3,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 31,464. Rates were audited or validated. The pandemic is reported to have had a negative impact on immunizations, as reflected in our rates.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,43.9,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Our FFS population is excluded. This measure is calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rate was audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical. Additionally, we added the Adult Expansion Population in July 2021, which would include new members in the 18+ age group.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,22.6,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 27,903. Rates were audited or validated. The pandemic is reported to have had a negative impact on immunizations, as reflected in our rates.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,54.0,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 27,903. Rates were audited or validated. The pandemic is reported to have had a negative impact on immunizations, as reflected in our rates.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,70.1,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 316,498. Rates were audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,61.5,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 316,498. Rates were audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,54.7,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Denominator is the sample size; measure-eligible population is 316,498. Rates were audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,50.1,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.",Yes
Missouri,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,59.0,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Our FFS population is excluded. This measure is only calculated by our MCOs, since our child FFS population is quite small."" The state described the ""other"" data sources used to calculate the measure as the following: ""Our managed care organizations perform this analysis using their own claims."" Rates were audited or validated. We have not been disenrolling people during the pandemic; thus our numerators and denominators are higher than is typical.",Yes
Montana,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.3,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Montana,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,20.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Nebraska,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,13.5,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,52.6,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,74.3,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,57.5,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,65.6,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,39.6,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,47.6,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,NR,45,52.4,47.6,58.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,NR,45,35.3,28.6,41.9,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,27.1,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,59.0,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,32.4,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,79.2,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,69.5,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,74.0,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,28.8,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.8,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,34,5.7,3.8,8.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,33.7,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,14.9,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.7,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Nebraska,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,20.5,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Nebraska,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative & Hybrid,55.5,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rate was derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is not available.",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,50.0,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,53.9,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,22.5,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,47.7,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,87.5,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Sample size and measure-eligible population are not available.",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,60.6,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Sample size and measure-eligible population are not available.",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,71.9,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Sample size and measure-eligible population are not available.",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,50.4,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Sample size and measure-eligible population are not available.",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,27.7,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative & Hybrid,28.1,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rate was derived using both administrative and hybrid method data. Two plans used administrative data and 1 plan used the hybrid method. The measure-eligible population is 21,454.",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,32.1,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rates were derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is 6,339.",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,76.5,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rates were derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is 6,339.",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,44.8,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rates were derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is 67,677.",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,NR,43,63.6,36.7,74.3,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rates were derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is 67,677.",No
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,NR,43,58.4,35.5,71.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rates were derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is 67,677.",No
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,62.9,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,67.7,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nevada,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,45.1,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,68.0,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,46.6,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,67.1,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,51.9,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,65.9,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,50.0,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (3 MCOs). Rates were audited or validated. Continuation & Maintenance phase rate not reported as the statewide rate aligned with the specifications, but the denominator was too small (<30) to report a valid rate.",No
Nevada,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,NR,49,54.1,45.1,59.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (3 MCOs). Rates were audited or validated. Continuation & Maintenance phase rate not reported as the statewide rate aligned with the specifications, but the denominator was too small (<30) to report a valid rate.",No
Nevada,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid only,Administrative,44.3,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,33.1,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,31.1,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,CHIP only,Administrative,44.3,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,35.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,35.7,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid only,Administrative,56.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Nevada,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,CHIP only,Administrative,67.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes managed care population (3 MCOs). Rate was audited or validated.,No
Nevada,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid only,Administrative,28.3,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Nevada,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,CHIP only,Administrative,16.2,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes managed care population (3 MCOs). Rate was audited or validated.,No
Nevada,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid only,Administrative,79.1,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid only,Administrative,66.9,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid only,Administrative,73.3,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,CHIP only,Administrative,81.5,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,CHIP only,Administrative,67.3,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,CHIP only,Administrative,74.1,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,15.0,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,2.1,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,5.5,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (3 MCOs).,No
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,0.9,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (3 MCOs).,No
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,2.5,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,21.7,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (3 MCOs).,No
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,6.8,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,#,34,5.7,3.8,8.5,# = Rate not reported because denominator is less than 30,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (3 MCOs).,No
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,DS,40,39.4,34.1,44.2,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (3 MCOs).,No
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,#,30,3.1,1.6,4.9,# = Rate not reported because denominator is less than 30,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (3 MCOs).,No
Nevada,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,DS,40,15.3,12.1,18.0,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (3 MCOs).,No
Nevada,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.0,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Nevada,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,25.0,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Nevada,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid only,Hybrid,82.8,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 11,533.",Yes
Nevada,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,CHIP only,NR,NR,47,81.5,75.2,87.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid only,Administrative,49.8,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid only,Administrative,44.8,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid only,Administrative,20.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid only,Administrative,43.9,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,CHIP only,Administrative,53.0,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,CHIP only,Administrative,52.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,CHIP only,Administrative,30.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,CHIP only,Administrative,51.1,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid only,Hybrid,78.4,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 14,998. Rates were audited or validated.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid only,Hybrid,34.0,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 14,998. Rates were audited or validated.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid only,Hybrid,58.9,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 14,998. Rates were audited or validated.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid only,Hybrid,26.6,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 14,998. Rates were audited or validated.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,CHIP only,Hybrid,88.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,CHIP only,Hybrid,49.5,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,CHIP only,Hybrid,74.2,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,CHIP only,Hybrid,40.3,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Denominator is the measure-eligible population. Rates were audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid only,Administrative,53.4,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,CHIP only,Administrative,50.8,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes managed care population (3 MCOs). Rate was audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid only,Administrative,36.8,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (3 MCOs). Due to COVID-19, FFY 2022 rates may not be comparable to previous years.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,CHIP only,Administrative,43.2,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes FFS and managed care populations (3 MCOs).,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid only,Hybrid,34.6,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 12,353. Rates were audited or validated. Due to COVID-19, FFY 2022 rates may not be comparable to previous years.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid only,Hybrid,81.8,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 12,353. Rates were audited or validated. Due to COVID-19, FFY 2022 rates may not be comparable to previous years.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,CHIP only,Hybrid,46.5,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 1,312. Rates were audited or validated.",No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,CHIP only,Hybrid,89.7,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 1,312. Rates were audited or validated.",No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid only,Hybrid,82.7,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 125,956. Rates were audited or validated.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid only,Hybrid,75.1,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 125,956. Rates were audited or validated.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid only,Hybrid,71.6,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 125,956. Rates were audited or validated.",Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,CHIP only,Hybrid,83.9,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 10,590. Rates were audited or validated.",No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,CHIP only,Hybrid,75.5,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 10,590. Rates were audited or validated.",No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,CHIP only,Hybrid,72.2,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 10,590. Rates were audited or validated.",No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid only,Administrative,57.7,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid only,Administrative,60.2,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,CHIP only,Administrative,63.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
Nevada,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,CHIP only,Administrative,73.0,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include managed care population (3 MCOs). Rates were audited or validated.,No
New Hampshire,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rate was audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",No
New Hampshire,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,73.5,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,84.0,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,73.7,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Includes paid and denied claims/encounters. Members were assigned to a plan based on their latest enrollment date within the calendar year. There was no consideration for members who may have died during the measurement period.",Yes
New Hampshire,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,85.1,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Includes paid and denied claims/encounters. Members were assigned to a plan based on their latest enrollment date within the calendar year. There was no consideration for members who may have died during the measurement period.",Yes
New Hampshire,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,43.7,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,46.5,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,56.4,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,36.1,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,35.1,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,65.5,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rate was audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,27.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rate was audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,81.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,67.5,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,74.3,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,62.9,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Medicare and Medicaid dual eligibles and members with dental third-party liability excluded. Includes paid and denied claims. State did note an increase in the denominator as it is based on increased enrollment due to COVID-19. However, state didn't note a large increase in the numerator, therefore there is a drop in the rate this year.",Yes
New Hampshire,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,43.9,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Medicare and Medicaid dual eligibles and members with dental third-party liability excluded. Includes paid and denied claims. State did note an increase in the denominator as it is based on increased enrollment due to COVID-19. However, state didn't note a large increase in the numerator, therefore there is a drop in the rate this year.",Yes
New Hampshire,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,37.6,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated.",Yes
New Hampshire,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,6.2,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated.",Yes
New Hampshire,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,8.8,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated.",Yes
New Hampshire,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,47.4,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated.",Yes
New Hampshire,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated.",No
New Hampshire,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,22.2,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated.",Yes
New Hampshire,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.3,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
New Hampshire,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,28.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
New Hampshire,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,82.1,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 2,838. Rate was audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,66.4,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,58.0,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,33.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,58.3,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,85.2,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 4,246. Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,57.6,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 4,246. Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,67.6,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 4,246. Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,43.1,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 4,246. Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,44.7,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rate was audited or validated. Submitted values are based on HEDIS data for reporting year 2022.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,28.1,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system.""",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,32.9,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 4,961. Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,72.2,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 4,961. Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,70.6,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 59,546. Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,68.8,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 59,546. Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,64.6,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 59,546. Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,55.7,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Hampshire,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,75.6,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,13.9,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,62.9,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,71.8,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,21.7,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,44.5,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,30.8,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS MY2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,35.4,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS MY2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,47.7,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,38.9,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,33.0,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,63.3,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,31.3,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,74.9,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,68.7,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,71.6,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,15.5,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,0.9,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.1,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,31.1,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",No
New Jersey,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.3,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.2,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
New Jersey,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.7,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
New Jersey,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,84.4,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 24,073. Rate was audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,67.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,62.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,38.9,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,60.9,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,82.2,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 38,127. Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,49.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 38,127. Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,57.0,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 38,127. Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,32.2,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 38,127. Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,57.6,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,44.2,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Oregon Health and Science University 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,33.3,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 39,214. Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,85.7,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 39,214. Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,86.4,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS MY2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 297,577. Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,82.7,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS MY2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 297,577. Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,79.5,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS MY2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 297,577. Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,51.4,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,71.1,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,8.7,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rate was audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,61.6,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,75.8,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,52.0,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,73.4,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,53.4,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,41.4,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,59.8,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,36.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,35.9,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,56.1,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rate was audited or validated.",Yes
New Mexico,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,26.0,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rate was audited or validated.",Yes
New Mexico,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,81.9,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,69.4,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,74.9,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,10.1,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
New Mexico,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,22.1,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
New Mexico,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,70.3,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 11,529. Rate was audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,47.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,41.1,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,15.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,39.5,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,84.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 15,034. Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,49.1,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 15,034. Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,63.8,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 15,034. Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,37.8,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 15,034. Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,43.0,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rate was audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,30.8,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 16,921. Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,77.9,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 16,921. Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,67.2,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 157,791. Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,58.2,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 157,791. Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,55.2,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 157,791. Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,50.5,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,57.1,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,12.8,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rate was audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,60.3,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,76.1,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,73.2,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,86.9,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,53.3,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,61.7,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,57.9,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,41.1,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,39.4,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,74.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rate was audited or validated.",Yes
New York,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,25.1,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rate was audited or validated. All available age ranges are entered.",Yes
New York,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,68.9,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,62.0,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,65.5,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid only,Administrative,45.4,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (23 MCOs). Rates were audited or validated.,Yes
New York,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid only,Administrative,12.7,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include managed care population (23 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,19.3,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (16 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,2.0,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (16 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,7.9,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (16 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,37.1,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (16 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,4.6,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (16 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,12.1,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (16 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.2,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
New York,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,27.1,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
New York,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,87.2,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 87,447. Rate was audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,76.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,71.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,48.6,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,69.7,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,84.3,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 113,958. Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,54.5,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 113,958. Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,66.7,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 113,958. Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,42.0,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 113,958. Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,71.4,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rate was audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,46.2,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 117,874. Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,84.8,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 117,874. Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,85.1,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 1,459,587. Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,84.2,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 1,459,587. Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,80.2,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Denominator is the sample size; measure-eligible population is 1,459,587. Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,66.7,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,78.2,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid only,Administrative,8.8,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,CHIP only,Administrative,#,25,10.6,6.0,16.3,# = Rate not reported because denominator is less than 30,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,52.3,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations. Rates were audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,70.1,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations. Rates were audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,CHIP only,Administrative,51.8,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,CHIP only,Administrative,69.0,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,35.2,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,59.3,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,39.9,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,64.7,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,45.6,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,61.1,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,43.5,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children includes ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,53.8,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children includes ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid only,Administrative,51.1,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,35.4,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,32.6,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,CHIP only,Administrative,55.2,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice includes children ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,33.6,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice includes children ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,30.5,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice includes children ages 6 through 18.,No
North Carolina,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid only,Administrative,45.0,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,CHIP only,Administrative,51.3,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid only,Administrative,33.0,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,CHIP only,Administrative,18.6,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. North Carolina Health Choice children include ages 6 through 18.,No
North Carolina,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid only,Administrative,73.4,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid only,Administrative,69.7,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid only,Administrative,71.5,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,CHIP only,Administrative,77.6,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice Children include ages 6 through 18.,No
North Carolina,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,CHIP only,Administrative,71.7,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice Children include ages 6 through 18.,No
North Carolina,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,CHIP only,Administrative,74.0,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice Children include ages 6 through 18.,No
North Carolina,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid only,Administrative,47.2,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,CHIP only,Administrative,56.1,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid only,Administrative,65.1,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid only,Administrative,43.4,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,CHIP only,Administrative,90.7,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18. Utilization of preventive care services may have been impacted by the COVID-19 pandemic and the implementation of NC Medicaid Managed Care on July 1, 2021.",No
North Carolina,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,CHIP only,Administrative,55.1,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18. Utilization of preventive care services may have been impacted by the COVID-19 pandemic and the implementation of NC Medicaid Managed Care on July 1, 2021.",No
North Carolina,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid only,Administrative,22.9,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,CHIP only,Administrative,29.5,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,27.2,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,3.5,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,23.5,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,2.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,8.8,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,44.0,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,4.4,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,16.4,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,DS,34,5.7,3.8,8.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,DS,40,39.4,34.1,44.2,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,Administrative,DS,40,15.3,12.1,18.0,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,12.2,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
North Carolina,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.2,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
North Carolina,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid only,Administrative,39.5,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,CHIP only,NR,NR,47,81.5,75.2,87.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid only,Administrative,55.9,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid only,Administrative,49.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid only,Administrative,21.7,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid only,Administrative,47.8,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,CHIP only,Administrative,53.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,CHIP only,Administrative,53.7,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,CHIP only,Administrative,34.8,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,CHIP only,Administrative,51.6,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid only,Administrative,87.1,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid only,Administrative,44.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid only,Administrative,68.7,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid only,Administrative,34.3,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,CHIP only,NR,NR,46,82.0,78.4,84.9,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,CHIP only,NR,NR,46,45.7,37.1,52.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,CHIP only,NR,NR,47,61.5,56.4,67.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,CHIP only,NR,NR,48,32.9,26.9,39.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid only,Administrative,53.0,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,CHIP only,Administrative,44.8,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid only,Administrative,74.7,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,CHIP only,NR,NR,37,34.7,27.3,51.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid only,Administrative,31.5,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid only,Administrative,82.2,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,CHIP only,Administrative,33.7,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,CHIP only,Administrative,86.9,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",CHIP rates include FFS and managed care populations (5 MCOs). Administrative data sources are claims/encounters and state immunization registry. Rates were audited or validated. NC Health Choice children include ages 6 through 18.,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid only,Administrative,29.1,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Additional BMI measurement data were obtained from NC Health Information Exchange Authority."" Rates were audited or validated.",Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid only,Administrative,15.7,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Additional BMI measurement data were obtained from NC Health Information Exchange Authority."" Rates were audited or validated.",Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid only,Administrative,6.8,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Additional BMI measurement data were obtained from NC Health Information Exchange Authority."" Rates were audited or validated.",Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,CHIP only,Administrative,28.2,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Additional BMI measurement data were obtained from NC Health Information Exchange Authority."" Rates were audited or validated. NC Health Choice children include ages 6 through 18. Utilization of preventive care services may have been impacted by the COVID-19 pandemic and the implementation of NC Medicaid Managed Care on July 1, 2021.",No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,CHIP only,Administrative,15.3,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Additional BMI measurement data were obtained from NC Health Information Exchange Authority."" Rates were audited or validated. NC Health Choice children include ages 6 through 18. Utilization of preventive care services may have been impacted by the COVID-19 pandemic and the implementation of NC Medicaid Managed Care on July 1, 2021.",No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,CHIP only,Administrative,7.1,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Additional BMI measurement data were obtained from NC Health Information Exchange Authority."" Rates were audited or validated. NC Health Choice children include ages 6 through 18. Utilization of preventive care services may have been impacted by the COVID-19 pandemic and the implementation of NC Medicaid Managed Care on July 1, 2021.",No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid only,Administrative,62.1,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid only,Administrative,66.4,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,CHIP only,NR,NR,48,57.5,51.3,61.0,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
North Carolina,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,CHIP only,NR,NR,48,65.1,60.4,71.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
North Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,22.4,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,58.0,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS population.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,76.0,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS population.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,32.6,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,56.2,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,30.9,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,35.5,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS and PCCM populations.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,62.4,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,44.6,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,43.3,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,54.3,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
North Dakota,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,30.4,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
North Dakota,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,93.9,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,90.1,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,91.6,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,32.8,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
North Dakota,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,44.6,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,28.1,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,14.2,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
North Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,27.9,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.1,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,DS,34,5.7,3.8,8.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS population.,No
North Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,34.4,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS population.,Yes
North Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS population.,No
North Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,12.1,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rates include FFS population.,Yes
North Dakota,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,8.6,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
North Dakota,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,20.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
North Dakota,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,91.5,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,37.8,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,37.9,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,14.5,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,35.8,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,83.4,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,58.7,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,65.6,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,44.1,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid only,Administrative,32.8,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Medicaid rate includes FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,25.8,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,63.5,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,87.6,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Administrative data sources are claims/encounters and state immunization registry.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,5.8,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,1.2,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,6.7,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,36.5,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,39.3,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
Ohio,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,11.1,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rate was audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,75.7,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,85.3,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,63.4,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,85.2,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,41.7,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,55.7,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,47.6,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,30.5,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,29.3,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,78.0,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rate was audited or validated.",Yes
Ohio,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,52.5,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rate was audited or validated.",Yes
Ohio,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,74.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,68.8,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,71.7,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,30.8,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.9,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,9.5,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,43.1,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,6.4,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,14.8,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.4,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Ohio,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,25.7,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Ohio,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,84.8,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 48,681. Rate was audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,55.3,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,49.8,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,25.0,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,48.6,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,80.3,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 62,369. Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,42.3,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 62,369. Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,59.6,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 62,369. Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,31.3,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 62,369. Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,53.2,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rate was audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,31.4,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 56,451. Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,75.3,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 56,451. Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,75.8,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 635,106. Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,64.1,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 635,106. Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,58.4,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 635,106. Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,57.7,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,62.3,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,5.6,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,46.9,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,65.4,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,40.4,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,64.2,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,50.9,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,60.8,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,41.9,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,20.1,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,19.4,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,58.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,62.3,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,92.4,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,88.2,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,90.6,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,42.3,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,42.4,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,28.5,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,18.1,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviations: ""The CMS measure specifications detail the method to identify dental claims by rendering provider taxonomy code. Currently, those codes are not in the data warehouse so claims were identified as dental claims by using State Category of Service (MAR COS). Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,28.4,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,5.9,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,42.8,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.0,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,12.7,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.9,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Oklahoma,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Oklahoma,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,25.6,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days."" Oklahoma bills prenatal and postpartum care with global billing codes. The rate with global billing codes is: Denominator: 22,262 Numerator: 6,713 Rate: 30.2%.",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,42.5,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,35.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,15.1,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,37.1,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,60.5,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" Administrative data sources are claims/encounters and state immunization registry. State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days."" The MMR results changed by a larger margin than any other category. This is a result of more claims identified as MMR in the OSSIIS data provided this year compared to last year which led to a higher compliance rate.",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,34.9,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" Administrative data sources are claims/encounters and state immunization registry. State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days."" The MMR results changed by a larger margin than any other category. This is a result of more claims identified as MMR in the OSSIIS data provided this year compared to last year which led to a higher compliance rate.",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,22.0,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" Administrative data sources are claims/encounters and state immunization registry. State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days."" The MMR results changed by a larger margin than any other category. This is a result of more claims identified as MMR in the OSSIIS data provided this year compared to last year which led to a higher compliance rate.",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,13.9,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" Administrative data sources are claims/encounters and state immunization registry. State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days."" The MMR results changed by a larger margin than any other category. This is a result of more claims identified as MMR in the OSSIIS data provided this year compared to last year which led to a higher compliance rate.",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,31.2,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,27.8,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,23.4,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" Administrative data sources are claims/encounters and state immunization registry. State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,62.0,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" Administrative data sources are claims/encounters and state immunization registry. State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,10.2,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,3.4,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,3.2,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,61.0,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,56.6,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oregon,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,69.0,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs).,Yes
Oregon,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,82.5,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs).,Yes
Oregon,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,58.0,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs).,Yes
Oregon,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,69.4,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs).,Yes
Oregon,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,21.4,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,38.5,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,16.0,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,8.1,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Oregon,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.4,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Oregon,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,80.0,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (16 CCOs). Denominator is the sample size; measure-eligible population is 12,915.",Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,54.7,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 CCOs). Rates were audited or validated. State reported the following deviations: ""Allowed well-care visits to be provided by any provider types.""",Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,46.9,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 CCOs). Rates were audited or validated. State reported the following deviations: ""Allowed well-care visits to be provided by any provider types.""",Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,20.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 CCOs). Rates were audited or validated. State reported the following deviations: ""Allowed well-care visits to be provided by any provider types.""",Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,46.3,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 CCOs). Rates were audited or validated. State reported the following deviations: ""Allowed well-care visits to be provided by any provider types.""",Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,79.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Administrative data sources are claims/encounters and state immunization registry.,Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,46.8,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Administrative data sources are claims/encounters and state immunization registry.,Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,61.0,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Administrative data sources are claims/encounters and state immunization registry.,Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,38.4,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Administrative data sources are claims/encounters and state immunization registry.,Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,42.7,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,68.0,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,36.8,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Administrative data sources are claims/encounters and state immunization registry.,Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,66.0,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Administrative data sources are claims/encounters and state immunization registry.,Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,59.1,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 CCOs). State reported the following deviations: ""Allowed well-care visits to be provided by any provider types.""",Yes
Oregon,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,66.9,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (16 CCOs). State reported the following deviations: ""Allowed well-care visits to be provided by any provider types.""",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid only,Administrative,12.4,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,54.4,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,70.9,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,52.1,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,75.8,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,40.1,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,48.9,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,75.8,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,65.8,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,63.5,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,63.0,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,34.3,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,77.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,72.5,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,75.1,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid only,Administrative,33.6,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated.",Yes
Pennsylvania,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,34.7,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,22.2,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid only,Administrative,17.4,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated.",Yes
Pennsylvania,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,28.8,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.1,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,14.6,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,44.3,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,8.6,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,16.1,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.1,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Pennsylvania,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,24.1,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Pennsylvania,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid only,Hybrid,89.0,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rate was audited or validated.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,65.5,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,60.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,36.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,59.0,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,86.8,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,51.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,69.6,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,39.7,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,51.8,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,61.0,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,40.2,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,85.3,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). Administrative data source is state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,83.6,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,77.7,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,74.7,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,65.2,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,72.2,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (18 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The sample size includes 8 Medicaid plans and 10 CHIP plans.",Yes
Puerto Rico,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,46.5,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,50.3,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,48.3,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,7.6,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,58.2,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated. Three MCOs reported data for the separate blood glucose testing rate and cholesterol testing rate. Four MCOs reported data for the combined blood glucose and cholesterol testing rate.",Yes
Puerto Rico,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,49.5,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated. Three MCOs reported data for the separate blood glucose testing rate and cholesterol testing rate. Four MCOs reported data for the combined blood glucose and cholesterol testing rate.",Yes
Puerto Rico,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,48.2,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated. Three MCOs reported data for the separate blood glucose testing rate and cholesterol testing rate. Four MCOs reported data for the combined blood glucose and cholesterol testing rate.",Yes
Puerto Rico,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,49.2,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,83.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,NR,47,77.3,73.2,80.7,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",No
Puerto Rico,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,NR,47,68.8,64.8,72.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",No
Puerto Rico,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,92.7,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,17.4,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,12.0,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,1.5,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,0.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,5.1,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,13.0,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,0.0,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,1.3,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.0,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Puerto Rico,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,47.2,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Puerto Rico,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,57.1,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,NR,49,54.2,49.8,60.7,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",No
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,NR,49,49.0,43.4,55.4,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",No
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,NR,49,22.5,19.9,30.4,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",No
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,33.5,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,53.2,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,5.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,2.3,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,0.2,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,60.8,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,14.3,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,18.6,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,40.6,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,22.3,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,22.7,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,16.2,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rate was audited or validated.",No
Rhode Island,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,59.2,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,73.5,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,65.4,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,79.8,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,48.3,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,57.8,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,43.6,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,32.8,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,30.3,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,62.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rate was audited or validated.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,25.4,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rate was audited or validated.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,72.4,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,62.9,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,67.6,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,8.8,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Rhode Island,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,26.5,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Rhode Island,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,89.2,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,67.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,62.8,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,38.6,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,60.4,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,90.0,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,72.4,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,76.3,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,61.5,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,62.8,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rate was audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,46.1,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,83.6,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,88.3,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,82.7,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,80.3,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,68.9,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,77.5,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
South Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,5.6,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,57.0,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,73.3,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,52.4,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,76.1,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,35.6,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,50.5,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,55.0,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,34.9,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,33.1,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,61.3,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,33.0,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,80.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,73.4,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,77.0,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,47.9,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,9.4,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,4.8,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,22.6,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,27.9,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients.,Yes
South Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.0,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients.,Yes
South Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,11.7,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients,Yes
South Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,43.6,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients,Yes
South Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,6.9,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients,Yes
South Carolina,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,14.7,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients,Yes
South Carolina,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,12.5,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
South Carolina,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,26.5,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
South Carolina,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,87.6,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 20,512. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,52.8,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,48.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,20.8,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,46.8,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,82.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 28,626. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,36.1,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 28,626. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,61.5,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 28,626. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,27.1,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 28,626. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,56.2,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,50.7,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported the following deviation: ""Continuous enrollment criteria not applied."" Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,35.9,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 28,727. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,72.5,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the sample size; measure-eligible population is 28,727. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,72.7,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 325,688. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,65.9,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 325,688. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,63.5,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 325,688. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,54.3,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,70.5,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,No
South Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,54.3,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,64.2,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,31.4,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,57.9,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,44.3,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,47.3,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,52.4,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,28.1,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,27.1,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,56.4,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. State reported that the rate excludes the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the psychosocial care."" State reported the following deviations: ""Since psychosocial care at community mental health centers counts towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for community mental health centers funded through the Department of Social Services.""",Yes
South Dakota,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,28.3,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,87.9,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,67.6,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,77.1,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,38.5,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,65.4,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,47.0,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,29.1,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.9,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,6.2,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,39.8,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.3,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,18.9,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.0,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
South Dakota,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,18.6,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
South Dakota,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,36.5,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,36.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,34.5,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,14.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,33.0,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,69.1,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Administrative data sources are claims/encounters and state immunization registry.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,48.5,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Administrative data sources are claims/encounters and state immunization registry.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,45.0,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Administrative data sources are claims/encounters and state immunization registry.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,32.6,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Administrative data sources are claims/encounters and state immunization registry.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,20.0,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,15.0,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,37.2,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Administrative data sources are claims/encounters and state immunization registry.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,66.0,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Administrative data sources are claims/encounters and state immunization registry.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,41.3,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,43.9,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,6.0,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,49.8,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,69.4,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,51.7,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,75.4,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,40.8,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,54.3,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,54.3,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,41.3,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,38.1,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,58.8,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Tennessee,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,36.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Tennessee,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,77.3,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,70.5,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,74.0,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,42.8,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported the following deviation: ""Additional taxonomy code for Tennessee Health Department included in calculation for numerator.""",Yes
Tennessee,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,55.6,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported the following deviation: ""Additional taxonomy code for Tennessee Health Department included in calculation for numerator.""",Yes
Tennessee,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,38.3,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported the following deviation: ""Additional taxonomy code for Tennessee Health Department included in calculation for numerator.""",Yes
Tennessee,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,18.6,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported the following deviation: ""Additional taxonomy code for Tennessee Health Department included in calculation for numerator.""",Yes
Tennessee,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,29.4,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.0,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,6.3,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,43.2,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,3.5,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,15.2,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.0,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Tennessee,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,25.0,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Tennessee,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,84.1,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Denominator is the measure-eligible population. Rate was audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,59.3,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,50.6,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,24.5,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,51.0,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,82.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,44.3,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,65.0,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,34.4,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,47.6,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,61.2,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,32.0,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,74.5,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Administrative data sources are claims/encounters and state immunization registry. Denominator is the measure-eligible population. Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,78.5,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Sample size is 748; measure-eligible population is 301,326. Rates were audited or validated.",Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,67.7,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Sample size is 748; measure-eligible population is 301,326. Rates were audited or validated.",Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,65.2,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Sample size is 748; measure-eligible population is 301,326. Rates were audited or validated.",Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,60.7,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,65.0,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid only,Administrative,5.0,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,CHIP only,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,43.9,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,58.2,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,CHIP only,Administrative,51.4,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,CHIP only,Administrative,66.8,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,42.8,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,68.5,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,41.5,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,69.0,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,39.8,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,54.9,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,34.5,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,43.0,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid only,Administrative,54.5,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,39.3,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,37.9,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,CHIP only,Administrative,54.6,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,37.2,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,35.4,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid only,Administrative,43.3,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,CHIP only,Administrative,42.4,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",No
Texas,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid only,Administrative,35.6,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,CHIP only,Administrative,15.2,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",No
Texas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid only,Administrative,75.2,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid only,Administrative,67.9,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid only,Administrative,71.6,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,CHIP only,Administrative,87.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,CHIP only,Administrative,77.7,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,CHIP only,Administrative,82.9,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid only,Administrative,63.3,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Dental encounters and enrollment data."" Rate was audited or validated.",Yes
Texas,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,CHIP only,Administrative,60.5,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Dental encounters and enrollment data."" Rate was audited or validated.",No
Texas,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid only,Administrative,66.5,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Dental encounter data and dental enrollment."" Rates were audited or validated.",Yes
Texas,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid only,Administrative,43.4,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Dental encounter data and dental enrollment."" Rates were audited or validated.",Yes
Texas,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,CHIP only,Administrative,65.5,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Dental encounter data and dental enrollment."" Rates were audited or validated.",No
Texas,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,CHIP only,Administrative,44.8,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Dental encounter data and dental enrollment."" Rates were audited or validated.",No
Texas,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid only,Administrative,33.7,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Dental encounter data and dental enrollment."" Rate was audited or validated.",Yes
Texas,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,CHIP only,Administrative,31.5,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Dental encounters and enrollment data."" Rate was audited or validated.",No
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,16.9,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,3.5,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,CHIP only,NR,NR,40,26.3,19.1,29.3,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,CHIP only,NR,NR,40,3.4,2.7,4.7,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,3.1,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,36.4,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,1.6,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,15.4,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,NR,NR,34,5.7,3.8,8.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,NR,NR,40,39.4,34.1,44.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,NR,NR,30,3.1,1.6,4.9,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Texas,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,NR,NR,40,15.3,12.1,18.0,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Texas,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.5,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Texas,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,26.7,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Texas,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid only,Administrative & Hybrid,83.9,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was derived using both administrative and hybrid method data. Hybrid data was used for State of Texas Access Reform (STAR) (16 MCOs). Other managed care programs (a total of 11 MCOs) and FFS used administrative data. Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Texas,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,CHIP only,Administrative,DS,47,81.5,75.2,87.2,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid only,Administrative,64.4,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid only,Administrative,60.6,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid only,Administrative,30.5,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid only,Administrative,59.1,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,CHIP only,Administrative,64.7,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,CHIP only,Administrative,62.9,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,CHIP only,Administrative,44.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,CHIP only,Administrative,62.7,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid only,Administrative & Hybrid,84.7,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid only,Administrative & Hybrid,39.5,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid only,Administrative & Hybrid,62.8,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid only,Administrative & Hybrid,29.6,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,CHIP only,Hybrid,90.9,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,CHIP only,Hybrid,52.7,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,CHIP only,Hybrid,72.1,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,CHIP only,Hybrid,40.2,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid only,Administrative,47.2,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,CHIP only,Administrative,37.9,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid only,Administrative,46.4,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,CHIP only,Administrative,47.7,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid only,Administrative & Hybrid,42.5,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were derived using both administrative and hybrid method data. The measure was based on hybrid data for State of Texas Access Reform (STAR) and STAR Kids (a combined total of 16 MCOs). Administrative data was used for FFS and STAR Health (1 MCO). The measure-eligible population is 10,275. Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid only,Administrative & Hybrid,85.3,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were derived using both administrative and hybrid method data. The measure was based on hybrid data for State of Texas Access Reform (STAR) and STAR Kids (a combined total of 16 MCOs). Administrative data was used for FFS and STAR Health (1 MCO). The measure-eligible population is 10,275. Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,CHIP only,Hybrid,43.7,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,CHIP only,Hybrid,87.4,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid only,Hybrid,74.8,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid only,Hybrid,73.5,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid only,Hybrid,70.0,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,CHIP only,Hybrid,75.3,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the sample size; measure-eligible population is 5,841. Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,CHIP only,Hybrid,73.4,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the sample size; measure-eligible population is 5,841. Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,CHIP only,Hybrid,70.8,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the sample size; measure-eligible population is 5,841. Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid only,Administrative,56.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid only,Administrative,70.3,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (16 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,CHIP only,Administrative,NR,48,57.5,51.3,61.0,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Texas,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,CHIP only,Administrative,79.0,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",No
Utah,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid only,NR,NR,48,47.9,40.1,57.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Utah,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid only,NR,NR,48,70.4,62.1,79.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Utah,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,38.2,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (1 MCO). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan submits independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",Yes
Utah,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,55.9,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (1 MCO). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan submits independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",Yes
Utah,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,49.7,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics.""",Yes
Utah,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,27.0,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics.""",Yes
Utah,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,31.3,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",No
Utah,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,DS,49,54.1,45.1,59.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",No
Utah,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid only,NR,NR,47,62.6,58.6,67.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Utah,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,CHIP only,Administrative,DS,47,62.6,58.6,67.2,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rate was audited or validated.",No
Utah,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid only,Administrative,36.6,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics.""",Yes
Utah,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,CHIP only,Administrative,9.6,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rate was audited or validated.",No
Utah,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid only,Administrative,78.1,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics.""",Yes
Utah,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid only,Administrative,74.8,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics.""",Yes
Utah,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid only,Administrative,76.2,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics.""",Yes
Utah,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,CHIP only,Administrative,#,47,77.3,73.2,80.7,# = Rate not reported because denominator is less than 30,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",No
Utah,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,CHIP only,Administrative,#,47,68.8,64.8,72.5,# = Rate not reported because denominator is less than 30,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",No
Utah,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,CHIP only,Administrative,87.1,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",No
Utah,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.1,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Utah,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,20.4,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Utah,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid only,Administrative,69.3,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics.""",Yes
Utah,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,CHIP only,NR,NR,47,81.5,75.2,87.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
Utah,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid only,Administrative,49.5,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper.""",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid only,Administrative,41.4,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper.""",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid only,Administrative,20.2,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper.""",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid only,Administrative,44.4,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper.""",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,CHIP only,Administrative,58.4,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper."" Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,CHIP only,Administrative,50.6,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper."" Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,CHIP only,Administrative,30.6,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper."" Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,CHIP only,Administrative,53.1,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper."" Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid only,Hybrid,81.6,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size; measure-eligible population is 10,937.",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid only,Hybrid,47.9,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size; measure-eligible population is 10,937.",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid only,Hybrid,64.4,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size; measure-eligible population is 10,937.",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid only,Hybrid,39.5,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size; measure-eligible population is 10,937.",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,CHIP only,Hybrid,87.0,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,CHIP only,Hybrid,57.9,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,CHIP only,Hybrid,72.3,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,CHIP only,Hybrid,47.7,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid only,Administrative,35.7,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics.""",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,CHIP only,Administrative,18.3,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes managed care population (1 MCO). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan submits independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rate was audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid only,Hybrid,21.9,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the measure-eligible population.",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid only,Hybrid,51.2,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the measure-eligible population.",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,CHIP only,Hybrid,43.7,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,CHIP only,Hybrid,87.9,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid only,Hybrid,69.9,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records."" Denominator is the sample size; measure-eligible population is 82,867.",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid only,Hybrid,59.8,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records."" Denominator is the sample size; measure-eligible population is 82,867.",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid only,Hybrid,61.5,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records."" Denominator is the sample size; measure-eligible population is 82,867.",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,CHIP only,Hybrid,73.4,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records."" Denominator is the sample size; measure-eligible population is 4,241. Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,CHIP only,Hybrid,64.4,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records."" Denominator is the sample size; measure-eligible population is 4,241. Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,CHIP only,Hybrid,57.7,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records."" Denominator is the sample size; measure-eligible population is 4,241. Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid only,Administrative,50.9,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper.""",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid only,Administrative,65.0,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper.""",Yes
Utah,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,CHIP only,Administrative,73.6,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper."" Rates were audited or validated.",No
Utah,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,CHIP only,Administrative,76.8,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics; Medical Records; Both EHR and Paper."" Rates were audited or validated.",No
Vermont,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rate was audited or validated.",No
Vermont,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,86.0,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,89.9,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,70.7,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). The state described the ""other"" data sources used to calculate the measure as the following: ""Vermont Medicaid incorporates data from the Vermont Department of Health's database."" Rates were audited or validated.",Yes
Vermont,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,88.0,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). The state described the ""other"" data sources used to calculate the measure as the following: ""Vermont Medicaid incorporates data from the Vermont Department of Health's database."" Rates were audited or validated.",Yes
Vermont,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,60.4,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,67.0,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,51.1,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,26.8,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,25.8,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,74.7,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,28.1,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rate was audited or validated.",Yes
Vermont,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,67.4,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,60.5,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,64.0,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,22.8,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,10.8,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,34,5.7,3.8,8.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",No
Vermont,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,26.1,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",No
Vermont,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,20.9,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,8.9,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Vermont,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,25.9,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Vermont,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,81.5,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Denominator is the sample size; measure-eligible population is 1,956. Rate was audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,65.3,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,58.6,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,29.9,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,56.9,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,86.5,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Administrative data sources are claims/encounters and state immunization registry.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,61.0,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Administrative data sources are claims/encounters and state immunization registry.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,68.1,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Administrative data sources are claims/encounters and state immunization registry.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,45.0,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Administrative data sources are claims/encounters and state immunization registry.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,41.9,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rate was audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,52.2,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rate was audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,30.4,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Administrative data sources are claims/encounters and state immunization registry. Vermont Medicaid incorporates data from the Vermont Department of Health's Immunization Registry.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,74.7,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Administrative data sources are claims/encounters and state immunization registry. Vermont Medicaid incorporates data from the Vermont Department of Health's Immunization Registry.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,67.6,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Denominator is the sample size; measure-eligible population is 41,389. Rates were audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,65.2,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Denominator is the sample size; measure-eligible population is 41,389. Rates were audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,57.7,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Denominator is the sample size; measure-eligible population is 41,389. Rates were audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,70.0,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,79.5,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated.",Yes
Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,63.3,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,76.6,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,47.1,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,70.8,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,36.3,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,50.5,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,50.7,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,34.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,33.3,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,65.5,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,78.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the total Quality Compass HEDIS measure rate for the age stratifications for ages 5-11 and 12-18. Virginia is not reporting a combined rate including ages 5-18.",Yes
Virginia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,72.1,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the total Quality Compass HEDIS measure rate for the age stratifications for ages 5-11 and 12-18. Virginia is not reporting a combined rate including ages 5-18.",Yes
Virginia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,NR,48,73.1,68.1,76.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the total Quality Compass HEDIS measure rate for the age stratifications for ages 5-11 and 12-18. Virginia is not reporting a combined rate including ages 5-18.",No
Virginia,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.0,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Virginia,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,26.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Virginia,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Hybrid,75.4,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology."" Sample size and measure-eligible population are not available. Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,55.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,48.2,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,24.0,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,48.0,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Hybrid,82.6,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology. The six MCOs also utilized data from the immunization registry to report this measure."" Sample size and measure-eligible population are not available. Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Hybrid,47.9,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology. The six MCOs also utilized data from the immunization registry to report this measure."" Sample size and measure-eligible population are not available. Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,59.4,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology. The six MCOs also utilized data from the immunization registry to report this measure."" Sample size and measure-eligible population are not available. Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Hybrid,33.0,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology. The six MCOs also utilized data from the immunization registry to report this measure."" Sample size and measure-eligible population are not available. Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,48.5,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,35.0,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology. The six MCOs also utilized data from the immunization registry to report this measure."" Sample size and measure-eligible population are not available. Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Hybrid,70.5,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology. The six MCOs also utilized data from the immunization registry to report this measure."" Sample size and measure-eligible population are not available. Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,69.3,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology."" Sample size and measure-eligible population are not available. Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,61.1,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology."" Sample size and measure-eligible population are not available. Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,56.6,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology."" Sample size and measure-eligible population are not available. Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,59.6,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Virginia,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,66.6,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates.",Yes
Washington,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,22.2,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,64.9,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,77.1,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,63.7,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" Deviations for all rates: ""While specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,84.2,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" Deviations for all rates: ""While specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,42.9,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. To identify prescribing provider, we limited to the following servicing taxonomies: 207 (physician), 208 (General Practice/Hospitalist/Pediatrics/surgery/ preventive/psych etc), 204 (doctor of osteopathic medicine, oral surgery, etc), 175F (Naturopath), 367A (ARNP) 363L (NP), 363A (PA).""",Yes
Washington,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,54.3,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. To identify prescribing provider, we limited to the following servicing taxonomies: 207 (physician), 208 (General Practice/Hospitalist/Pediatrics/surgery/ preventive/psych etc), 204 (doctor of osteopathic medicine, oral surgery, etc), 175F (Naturopath), 367A (ARNP) 363L (NP), 363A (PA).""",Yes
Washington,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,53.3,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,29.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,28.1,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,63.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs). State reported that the rate excludes the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,25.2,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs). State reported that the rate excludes the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications state that only services paid, or expected to be paid, should be counted. However, since managed care encounter claims may not have amounts on the claim, we have included all encounter claims, but have not included fee-for-service claims with paid amount of zero or less (replaced claims have already been excluded from our source file).""",Yes
Washington,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,81.5,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""While specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,70.8,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""While specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,75.5,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""While specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,52.3,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs). State reported that the rate excludes the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,67.7,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,44.8,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,22.5,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs). State reported that the rate excludes the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,24.3,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI instead of NDC to identify the applicable NDCs for specific methods. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Did not use S4993 alone as indication of oral contraception, as WA now also uses S4993 to indicate emergency contraception. Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,4.1,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI instead of NDC to identify the applicable NDCs for specific methods. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Did not use S4993 alone as indication of oral contraception, as WA now also uses S4993 to indicate emergency contraception. Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,2.0,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Used procedure code dates for delivery dates instead of the ICD-10 codes as they were more accurate when compared with birth certificate dates. Did not use the global OB code 59400 to identify births if it was paired with a diagnosis code for encounter for supervision of a pregnancy of less than 19 weeks gestation as this misidentified prenatal care as births. Reported using paid claims. The only denied claims included are denied lines from accepted encounters.""",Yes
Washington,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,38.1,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Used procedure code dates for delivery dates instead of the ICD-10 codes as they were more accurate when compared with birth certificate dates. Did not use the global OB code 59400 to identify births if it was paired with a diagnosis code for encounter for supervision of a pregnancy of less than 19 weeks gestation as this misidentified prenatal care as births. Reported using paid claims. The only denied claims included are denied lines from accepted encounters.""",Yes
Washington,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,0.8,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Used procedure code dates for delivery dates instead of the ICD-10 codes as they were more accurate when compared with birth certificate dates. Did not use the global OB code 59400 to identify births if it was paired with a diagnosis code for encounter for supervision of a pregnancy of less than 19 weeks gestation as this misidentified prenatal care as births. Reported using paid claims. The only denied claims included are denied lines from accepted encounters.""",Yes
Washington,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,18.1,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Used procedure code dates for delivery dates instead of the ICD-10 codes as they were more accurate when compared with birth certificate dates. Did not use the global OB code 59400 to identify births if it was paired with a diagnosis code for encounter for supervision of a pregnancy of less than 19 weeks gestation as this misidentified prenatal care as births. Reported using paid claims. The only denied claims included are denied lines from accepted encounters.""",Yes
Washington,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,7.8,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Washington,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,22.6,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Washington,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,88.8,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (5 MCOs). State reported that the rate excludes the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" Administrative data sources are claims/encounters and vital records. State reported the following deviations: ""Evaluated first trimester based on gestational age at birth in addition to the specified 176-280 days before delivery; since our administrative records always have an enrollment start date of the first of the month, for this analysis estimation of 42 days from enrollment start has been calculated from the 15th of the month to spread out bias for administrative vs actual start of enrollment; excludes records with missing birth certificate information about when prenatal care began that were not otherwise in the numerator (6.8 % of otherwise eligible women); measurement period is calendar year; rates include paid claims and denied lines from otherwise accepted encounters.""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,53.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. Technical specifications state that the visit must occur with a PCP. Washington has assumed that the targeted medical codes will be associated with appropriate personnel and is not applying this screen due to the likelihood of underrepresenting enrollees' qualifying visits.""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,47.1,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. Technical specifications state that the visit must occur with a PCP. Washington has assumed that the targeted medical codes will be associated with appropriate personnel and is not applying this screen due to the likelihood of underrepresenting enrollees' qualifying visits.""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,19.9,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. Technical specifications state that the visit must occur with a PCP. Washington has assumed that the targeted medical codes will be associated with appropriate personnel and is not applying this screen due to the likelihood of underrepresenting enrollees' qualifying visits.""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,45.9,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. Technical specifications state that the visit must occur with a PCP. Washington has assumed that the targeted medical codes will be associated with appropriate personnel and is not applying this screen due to the likelihood of underrepresenting enrollees' qualifying visits.""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,80.2,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Birth Certificate Data."" The state reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. We included vaccine-specific indicator CPT codes that were outside of specifications but have occurred in our Immunization Information System data (such as age-inappropriate codes or combination vaccines).""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,49.5,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Birth Certificate Data."" The state reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. We included vaccine-specific indicator CPT codes that were outside of specifications but have occurred in our Immunization Information System data (such as age-inappropriate codes or combination vaccines).""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,59.8,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Birth Certificate Data."" The state reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. We included vaccine-specific indicator CPT codes that were outside of specifications but have occurred in our Immunization Information System data (such as age-inappropriate codes or combination vaccines).""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,36.8,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" Administrative data sources are claims/encounters and state immunization registry. The state described the ""other"" data sources used to calculate the measure as the following: ""Birth Certificate Data."" The state reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters. We included vaccine-specific indicator CPT codes that were outside of specifications but have occurred in our Immunization Information System data (such as age-inappropriate codes or combination vaccines).""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,43.5,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs). State reported that the rate excludes the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,35.0,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" Administrative data sources are claims/encounters and state immunization registry. State matched Medicaid records with Washington State Immunization Information System data to better capture immunization history. State reported the following deviations: ""Rates include paid claims and denied lines from otherwise accepted encounters; age-inappropriate or combination vaccines for Tdap were included when they had occurred in the State Immunization Information System data for denominator children, although they were not in the specifications. Additional codes used for Tdap: 90696, 90698, 90700, 90721, 90723.""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,72.2,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" Administrative data sources are claims/encounters and state immunization registry. State matched Medicaid records with Washington State Immunization Information System data to better capture immunization history. State reported the following deviations: ""Rates include paid claims and denied lines from otherwise accepted encounters; age-inappropriate or combination vaccines for Tdap were included when they had occurred in the State Immunization Information System data for denominator children, although they were not in the specifications. Additional codes used for Tdap: 90696, 90698, 90700, 90721, 90723.""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,75.7,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). State reported that rates exclude the following populations: ""FFS, PCCM, and managed care clients who meet the continuous eligibility requirement for Medicaid/CHIP but who were not enrolled in a single plan during the continuous eligibility enrollment, or who switched between FFS and Managed Care, are not included. HEDIS plan data were used for consistency, for avoidance of redundant work, because these rates are audited and are used as a basis for discussions with plans, and because, since most of our clients are enrolled in managed care, it is largely representative of our caseload."" The state noted: ""The measure eligible populations for each reporting unit are used to weight the rates."" Sample size is 1,277; measure-eligible population is 248,071. Rates were audited or validated.",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,63.6,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). State reported that rates exclude the following populations: ""FFS, PCCM, and managed care clients who meet the continuous eligibility requirement for Medicaid/CHIP but who were not enrolled in a single plan during the continuous eligibility enrollment, or who switched between FFS and Managed Care, are not included. HEDIS plan data were used for consistency, for avoidance of redundant work, because these rates are audited and are used as a basis for discussions with plans, and because, since most of our clients are enrolled in managed care, it is largely representative of our caseload."" The state noted: ""The measure eligible populations for each reporting unit are used to weight the rates."" Sample size is 1,277; measure-eligible population is 248,071. Rates were audited or validated.",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Hybrid,61.8,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). State reported that rates exclude the following populations: ""FFS, PCCM, and managed care clients who meet the continuous eligibility requirement for Medicaid/CHIP but who were not enrolled in a single plan during the continuous eligibility enrollment, or who switched between FFS and Managed Care, are not included. HEDIS plan data were used for consistency, for avoidance of redundant work, because these rates are audited and are used as a basis for discussions with plans, and because, since most of our clients are enrolled in managed care, it is largely representative of our caseload."" The state noted: ""The measure eligible populations for each reporting unit are used to weight the rates."" Sample size is 1,277; measure-eligible population is 248,071. Rates were audited or validated.",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,57.3,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" The state described the ""other"" data sources used to calculate the measure as the following: ""Birth Certificates (linking mom to baby to get additional visits on mom's record)."" The state reported the following deviations: ""Rates include paid claims and denied lines from otherwise accepted encounters. Specifications state that the visit must occur with a PCP but the state assumed that the targeted medical codes will be associated with appropriate personnel and is not applying this screen due to the likelihood of underrepresenting qualifying visits; since infant claims can be on the mother's Medicaid ID for up to 60 days after birth, state links infants to their mothers when possible and identifies any additional claims on the mother's Medicaid ID per the specified CPTs.""",Yes
Washington,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,64.3,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" The state described the ""other"" data sources used to calculate the measure as the following: ""Birth Certificates (linking mom to baby to get additional visits on mom's record)."" The state reported the following deviations: ""Rates include paid claims and denied lines from otherwise accepted encounters. Specifications state that the visit must occur with a PCP but the state assumed that the targeted medical codes will be associated with appropriate personnel and is not applying this screen due to the likelihood of underrepresenting qualifying visits; since infant claims can be on the mother's Medicaid ID for up to 60 days after birth, state links infants to their mothers when possible and identifies any additional claims on the mother's Medicaid ID per the specified CPTs.""",Yes
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid only,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: 1) age is as of Admission but the age groups were defined by end of measurement period; 2) continuous enrollment was adjusted; 3) most health plans do not carve out chemical dependency, so this requirement was dropped; 4) the rate evaluates only the first two events to meet the allowable adjustment criteria; 5) no restrictions on data type for the files that are submitted for processing.",No
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,CHIP only,NR,NR,25,10.6,6.0,16.3,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,5.4,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid only,Administrative,11.5,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,CHIP only,Administrative,52.2,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from MMIS.""",No
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,CHIP only,Administrative,69.6,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from MMIS.""",No
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,8.8,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid only,Administrative,43.2,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,24.5,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: 1) age is as of Admission but the age groups were defined by end of measurement period; 2) continuous enrollment was adjusted; 3) most health plans do not carve out chemical dependency, so this requirement was dropped; 4) the rates evaluate only the first two events to meet the allowable adjustment criteria; 5) no restrictions on data type for the files that are submitted for processing.",No
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,CHIP only,Administrative,38.8,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: 1) age is as of Admission but the age groups were defined by end of measurement period; 2) continuous enrollment was adjusted; 3) most health plans do not carve out chemical dependency, so this requirement was dropped; 4) the rates evaluate only the first two events to meet the allowable adjustment criteria; 5) no restrictions on data type for the files that are submitted for processing.",No
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,41.9,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid only,Administrative,54.3,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,46.2,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: 1) The Age range was defined with a relative date of 10 months from start of the measurement year to end age range of 10 months from the end of measurement year. 2) No restrictions on data type for the files that are submitted for processing. 3) The results incorporate demographic and plan type information for the patient to allow focusing a specific population type.",No
West Virginia,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,CHIP only,Administrative,63.0,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: 1) The Age range was defined with a relative date of 10 months from start of the measurement year to end age range of 10 months from the end of measurement year. 2) No restrictions on data type for the files that are submitted for processing. 3) The results incorporate demographic and plan type information for the patient to allow focusing a specific population type.",No
West Virginia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid only,Administrative,74.3,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,59.5,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid only,Administrative,58.8,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,CHIP only,Administrative,58.6,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,28.7,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,CHIP only,Administrative,28.7,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid only,Administrative,43.6,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,CHIP only,Administrative,55.3,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid only,Administrative,74.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,CHIP only,Administrative,48.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Includes paid claims only; pending claims are not included.""",No
West Virginia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid only,Administrative,78.4,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Only MCO members are included."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid only,Administrative,65.8,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Only MCO members are included."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid only,Administrative,70.9,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Only MCO members are included."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,CHIP only,NR,NR,47,77.3,73.2,80.7,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
West Virginia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,CHIP only,NR,NR,47,68.8,64.8,72.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
West Virginia,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,CHIP only,NR,NR,48,73.1,68.1,76.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
West Virginia,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid only,Administrative,29.9,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Results were not limited by taxonomy code, as they are not always present within the data warehouse.""",Yes
West Virginia,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,CHIP only,Administrative,45.6,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Results were not limited by taxonomy code, as they are not always present within the data warehouse.""",No
West Virginia,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid only,Administrative,7.6,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse separate from MMIS.""",Yes
West Virginia,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid only,Administrative,3.5,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse separate from MMIS.""",Yes
West Virginia,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,CHIP only,Administrative,8.1,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from the MMIS.""",No
West Virginia,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,CHIP only,Administrative,4.1,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from the MMIS.""",No
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,36.6,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Only paid claims are utilized in our rule measure calculations.""",Yes
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid only,Administrative,3.3,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Only paid claims are utilized in our rule measure calculations.""",Yes
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,36.9,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Only paid claims are utilized in our rule measure calculations.""",No
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,CHIP only,Administrative,2.4,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Only paid claims are utilized in our rule measure calculations.""",No
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,5.0,34,5.7,3.8,8.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The logic includes the following allowable adjustments: 1) The Age was defined based on the end of the measurement year. 2) Denominator Period is set to a relative time from the start of the year prior to 6-months from the measurement period end date. 3) No restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,44.5,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The logic includes the following allowable adjustments: 1) The Age was defined based on the end of the measurement year. 2) Denominator Period is set to a relative time from the start of the year prior to 6-months from the measurement period end date. 3) No restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,2.8,30,3.1,1.6,4.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The logic includes the following allowable adjustments: 1) The Age was defined based on the end of the measurement year. 2) Denominator Period is set to a relative time from the start of the year prior to 6-months from the measurement period end date. 3) No restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid only,Administrative,12.1,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The logic includes the following allowable adjustments: 1) The Age was defined based on the end of the measurement year. 2) Denominator Period is set to a relative time from the start of the year prior to 6-months from the measurement period end date. 3) No restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,NR,NR,34,5.7,3.8,8.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,NR,NR,40,39.4,34.1,44.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,CHIP only,NR,NR,30,3.1,1.6,4.9,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
West Virginia,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,CHIP only,NR,NR,40,15.3,12.1,18.0,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
West Virginia,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,11.7,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
West Virginia,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,25.8,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
West Virginia,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid only,Hybrid,86.9,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 7,981. Rate was audited or validated.",Yes
West Virginia,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,CHIP only,NR,NR,47,81.5,75.2,87.2,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",None,No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid only,Administrative,37.3,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Medicare and Medicaid dual eligible individuals are excluded as data was extracted from the State's MCOs HEDIS reports for FFY 2022."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid only,Administrative,30.6,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Medicare and Medicaid dual eligible individuals are excluded as data was extracted from the State's MCOs HEDIS reports for FFY 2022."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid only,Administrative,15.5,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Medicare and Medicaid dual eligible individuals are excluded as data was extracted from the State's MCOs HEDIS reports for FFY 2022."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid only,Administrative,31.7,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Medicare and Medicaid dual eligible individuals are excluded as data was extracted from the State's MCOs HEDIS reports for FFY 2022."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,CHIP only,Administrative,54.0,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,CHIP only,Administrative,45.8,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,CHIP only,Administrative,31.8,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,CHIP only,Administrative,48.9,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid only,Hybrid,86.5,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 9,309. Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid only,Hybrid,42.2,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 9,309. Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid only,Hybrid,66.8,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 9,309. Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid only,Hybrid,31.7,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 9,309. Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,CHIP only,Administrative,73.6,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" Allowable Adjustments for DTap, HiB, HAV, HBV, Flu, MMR, PCV, IPV, RV: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,CHIP only,Administrative,38.3,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" Allowable Adjustments for DTap, HiB, HAV, HBV, Flu, MMR, PCV, IPV, RV: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,CHIP only,Administrative,24.3,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" Allowable Adjustments for DTap, HiB, HAV, HBV, Flu, MMR, PCV, IPV, RV: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,CHIP only,Administrative,14.5,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" Allowable Adjustments for DTap, HiB, HAV, HBV, Flu, MMR, PCV, IPV, RV: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid only,Administrative,38.8,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Medicare and Medicaid dual eligible individuals are excluded as data was extracted from the State's MCOs HEDIS reports for FFY 2022."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rate was audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,CHIP only,Administrative,19.3,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" Allowable Adjustments: Age can be adjusted as long as age range was not changed or expanded. Age was defined based on the end of measurement year. Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid only,Administrative,51.6,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,CHIP only,Administrative,54.8,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid only,Hybrid,27.1,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 9,298. Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid only,Hybrid,79.6,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 9,298. Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,CHIP only,Administrative,16.9,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments for HPV, Meningococcal, Tdap/Td: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,CHIP only,Administrative,63.7,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments for HPV, Meningococcal, Tdap/Td: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid only,Hybrid,41.0,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Sample size is 1,233; measure-eligible population is 122,668. Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid only,Hybrid,36.7,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Sample size is 1,233; measure-eligible population is 122,668. Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid only,Hybrid,35.5,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Sample size is 1,233; measure-eligible population is 122,668. Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,CHIP only,Administrative,40.1,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Age can be adjusted as long as age range was not changed or expanded. Age was defined based on the end of the measurement year.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,CHIP only,Administrative,29.4,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Age can be adjusted as long as age range was not changed or expanded. Age was defined based on the end of the measurement year.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,CHIP only,Administrative,28.5,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Medicaid Data Warehouse Separate from MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Age can be adjusted as long as age range was not changed or expanded. Age was defined based on the end of the measurement year.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid only,Administrative,52.8,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Medicare and Medicaid dual eligible individuals are excluded as data was extracted from the State's MCOs HEDIS reports for FFY 2022."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid only,Administrative,71.0,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Medicaid rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Medicare and Medicaid dual eligible individuals are excluded as data was extracted from the State's MCOs HEDIS reports for FFY 2022."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,CHIP only,Administrative,51.9,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
West Virginia,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,CHIP only,Administrative,65.0,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","CHIP rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",No
Wisconsin,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,2.9,25,10.6,6.0,16.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was audited or validated.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,38.6,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,56.2,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,46.2,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,69.9,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative & Electronic Health Records,35.7,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative & Electronic Health Records,40.2,49,54.1,45.1,59.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,45.4,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated. The rates for FFY 2022 may not be directly comparable to those of previous years, as the stay-at-home mandate in previous years and the NCQA's guidance to use hybrid rates from those years may affect the validity of such comparisons.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,21.8,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated. The rates for FFY 2022 may not be directly comparable to those of previous years, as the stay-at-home mandate in previous years and the NCQA's guidance to use hybrid rates from those years may affect the validity of such comparisons.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,20.6,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated. The rates for FFY 2022 may not be directly comparable to those of previous years, as the stay-at-home mandate in previous years and the NCQA's guidance to use hybrid rates from those years may affect the validity of such comparisons.",Yes
Wisconsin,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,63.2,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was audited or validated.",Yes
Wisconsin,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,75.7,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,66.2,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,70.9,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,10.5,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Wisconsin,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,23.5,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Wisconsin,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative & Hybrid,84.2,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,54.2,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,47.6,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,25.0,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,47.6,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative & Hybrid,80.3,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,46.4,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,58.9,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,35.3,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative & Electronic Health Records,46.0,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,38.4,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative & Hybrid,73.0,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,59.8,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were derived using both administrative and hybrid method data. The measure-eligible population is 14,000. Rates were audited or validated. The rates for FFY 2022 may not be directly comparable to those of previous years, as the stay-at-home mandate in previous years and the NCQA's guidance to use hybrid rates from those years may affect the validity of such comparisons.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,27.9,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were derived using both administrative and hybrid method data. The measure-eligible population is 14,000. Rates were audited or validated. The rates for FFY 2022 may not be directly comparable to those of previous years, as the stay-at-home mandate in previous years and the NCQA's guidance to use hybrid rates from those years may affect the validity of such comparisons.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative & Hybrid,25.6,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were derived using both administrative and hybrid method data. The measure-eligible population is 14,000. Rates were audited or validated. The rates for FFY 2022 may not be directly comparable to those of previous years, as the stay-at-home mandate in previous years and the NCQA's guidance to use hybrid rates from those years may affect the validity of such comparisons.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,51.2,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,60.2,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wyoming,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Ages 13 to 17,FUA-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 13 to 17,2022,Medicaid & CHIP,Administrative,DS,25,10.6,6.0,16.3,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,No
Wyoming,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,48.6,40,54.6,46.2,65.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Child Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Ages 6 to 17,FUM-CH,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,72.0,40,72.7,63.6,76.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,55.1,48,47.9,40.1,57.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Child Core Set,Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17,FUH-CH,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 6 to 17,2022,Medicaid & CHIP,Administrative,80.0,48,70.4,62.1,79.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with 1 Follow-Up Visit During the 30-Day Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,36.2,50,43.0,36.4,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Child Core Set,Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Ages 6 to 12,ADD-CH,Higher rates are better for this measure,Percentage Newly Prescribed ADHD Medication with at Least 2 Follow-Up Visits in the 9 Months Following the Initiation Phase: Ages 6 to 12,2022,Medicaid & CHIP,Administrative,DS,49,54.1,45.1,59.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,No
Wyoming,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,77.5,45,52.4,47.6,58.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,44.2,45,35.3,28.6,41.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Child Core Set,Metabolic Monitoring for Children and Adolescents on Antipsychotics: Ages 1 to 17,APM-CH,Higher rates are better for this measure,Percentage on Antipsychotics who Received Blood Glucose and Cholesterol Testing: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,43.5,46,33.2,27.3,41.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Child Core Set,Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Ages 1 to 17,APP-CH,Higher rates are better for this measure,Percentage who had a New Prescription for an Antipsychotic Medication and had Documentation of Psychosocial Care as First-Line Treatment: Ages 1 to 17,2022,Medicaid & CHIP,Administrative,69.2,47,62.6,58.6,67.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Care of Acute and Chronic Conditions,Child Core Set,Ambulatory Care: Emergency Department (ED) Visits: Ages 0 to 19,AMB-CH,Lower rates are better for this measure,"Emergency Department Visits per 1,000 Beneficiary Months: Ages 0 to 19",2022,Medicaid & CHIP,Administrative,19.7,46,31.9,36.2,26.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 11,2022,Medicaid & CHIP,Administrative,36.4,47,77.3,73.2,80.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviations: ""Omitted denominator Steps 2 (leukotriene modifiers or antibody inhibitors were the sole asthma medication dispensed) and 3.2 (beneficiaries with no asthma controller or reliever medications dispensed).""",Yes
Wyoming,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 12 to 18,2022,Medicaid & CHIP,Administrative,28.4,47,68.8,64.8,72.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviations: ""Omitted denominator Steps 2 (leukotriene modifiers or antibody inhibitors were the sole asthma medication dispensed) and 3.2 (beneficiaries with no asthma controller or reliever medications dispensed).""",Yes
Wyoming,Care of Acute and Chronic Conditions,Child Core Set,Asthma Medication Ratio: Ages 5 to 18,AMR-CH,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 5 to 18,2022,Medicaid & CHIP,Administrative,31.7,48,73.1,68.1,76.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported the following deviations: ""Omitted denominator Steps 2 (leukotriene modifiers or antibody inhibitors were the sole asthma medication dispensed) and 3.2 (beneficiaries with no asthma controller or reliever medications dispensed).""",Yes
Wyoming,Dental and Oral Health Services,Child Core Set,"Oral Evaluation, Dental Services: Ages <1 through 20",OEV-CH,Higher rates are better for this measure,Percentage of Enrolled Children Under Age 21 Who Received a Comprehensive or Periodic Oral Evaluation: Ages <1 through 20,2022,Medicaid & CHIP,Administrative,47.9,27,43.2,37.1,49.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received a Sealant on at Least One Permanent First Molar Tooth by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,7.9,30,46.4,38.4,57.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Dental and Oral Health Services,Child Core Set,Sealant Receipt on Permanent First Molars: Age 10,SFM-CH,Higher rates are better for this measure,Percentage of Children who Received Sealants on All Four Permanent First Molars by their 10th Birthdate,2022,Medicaid & CHIP,Administrative,4.9,30,32.9,23.6,40.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Dental and Oral Health Services,Child Core Set,Topical Fluoride for Children: Ages 1 through 20,TFL-CH,Higher rates are better for this measure,Percentage of Enrolled Children who Received at Least Two Topical Fluoride Applications as Dental or Oral Health Services: Total (Ages 1 through 20),2022,Medicaid & CHIP,Administrative,43.6,25,19.3,16.8,23.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,19.8,40,26.3,19.1,29.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: All Women Ages 15 to 20,CCW-CH,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,6.6,40,3.4,2.7,4.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,34,5.7,3.8,8.5,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,No
Wyoming,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,32.8,40,39.4,34.1,44.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,DS,30,3.1,1.6,4.9,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,No
Wyoming,Maternal and Perinatal Health,Child Core Set,Contraceptive Care: Postpartum Women Ages 15 to 20,CCP-CH,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 15 to 20,2022,Medicaid & CHIP,Administrative,21.9,40,15.3,12.1,18.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Child Core Set,"Live Births Weighing Less Than 2,500 Grams",LBW-CH,Lower rates are better for this measure,"Percentage of Live Births that Weighed Less Than 2,500 Grams",2022,Medicaid only,Administrative,9.8,52,10.1,11.1,9.2,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Wyoming,Maternal and Perinatal Health,Child Core Set,Low-Risk Cesarean Delivery,LRCD-CH,Lower rates are better for this measure,"Percentage of Nulliparous, Term, Singleton, in a Cephalic Presentation Births Delivered by Cesarean",2022,Medicaid only,Administrative,18.3,52,24.7,26.9,22.5,,"Mathematica analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of February 2, 2023.",CMS calculated rate using CDC WONDER data.,Yes
Wyoming,Maternal and Perinatal Health,Child Core Set,Prenatal and Postpartum Care: Timeliness of Prenatal Care,PPC-CH,Higher rates are better for this measure,"Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester, on or before the enrollment start date, or within 42 Days of Enrollment in Medicaid or CHIP",2022,Medicaid & CHIP,Administrative,91.1,47,81.5,75.2,87.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 11,2022,Medicaid & CHIP,Administrative,37.6,49,54.2,49.8,60.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 12 to 17,2022,Medicaid & CHIP,Administrative,36.4,49,49.0,43.4,55.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 18 to 21,2022,Medicaid & CHIP,Administrative,11.3,49,22.5,19.9,30.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Child and Adolescent Well-Care Visits: Ages 3 to 21,WCV-CH,Higher rates are better for this measure,Percentage with at Least 1 Well-Care Visit with a Primary Care Practitioner or Obstetrician/Gynecologist: Ages 3 to 21,2022,Medicaid & CHIP,Administrative,33.9,50,47.6,42.6,54.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,"Percentage who had a Measles, Mumps, and Rubella (MMR) Vaccination by their Second Birthday",2022,Medicaid & CHIP,Administrative,68.6,46,82.0,78.4,84.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage who had at Least Two Flu Vaccinations by their Second Birthday,2022,Medicaid & CHIP,Administrative,33.0,46,45.7,37.1,52.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 3) by their Second Birthday,2022,Medicaid & CHIP,Administrative,12.2,47,61.5,56.4,67.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Childhood Immunization Status: Age 2,CIS-CH,Higher rates are better for this measure,Percentage Up to Date on Immunizations (Combination 10) by their Second Birthday,2022,Medicaid & CHIP,Administrative,6.7,48,32.9,26.9,39.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Chlamydia Screening in Women Ages 16 to 20,CHL-CH,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 16 to 20,2022,Medicaid & CHIP,Administrative,29.3,49,47.2,42.7,58.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Developmental Screening in the First Three Years of Life: Ages 0 to 3,DEV-CH,Higher rates are better for this measure,"Percentage Screened for Risk of Developmental, Behavioral, and Social Delays Using a Standardized Screening Tool: Ages 0 to 3",2022,Medicaid & CHIP,Administrative,26.1,37,34.7,27.3,51.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Completing the Human Papillomavirus (HPV) Vaccine Series by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,41.2,47,35.0,31.5,40.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Immunizations for Adolescents: Age 13,IMA-CH,Higher rates are better for this measure,Percentage Receiving Meningococcal Conjugate and Tdap Vaccines (Combination 1) by Their 13th Birthday,2022,Medicaid & CHIP,Administrative,35.7,46,75.2,68.3,82.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Body Mass Index Percentile Documentation: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,8.8,44,71.9,59.1,81.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Nutrition: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,6.5,43,63.6,36.7,74.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Ages 3 to 17,WCC-CH,Higher rates are better for this measure,Counseling for Physical Activity: Ages 3 to 17,2022,Medicaid & CHIP,Administrative,10.6,43,58.4,35.5,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 6 or More Well-Child Visits with a Primary Care Practitioner during the First 15 Months of Life,2022,Medicaid & CHIP,Administrative,37.7,48,57.5,51.3,61.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Child Core Set,Well-Child Visits in the First 30 Months of Life,W30-CH,Higher rates are better for this measure,Percentage of Children who had 2 or More Well-Child Visits with a Primary Care Practitioner during the 15th to 30th Months of Life,2022,Medicaid & CHIP,Administrative,73.6,48,65.1,60.4,71.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Alabama,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,80.9,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,57.6,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,26.3,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,15.8,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,74.2,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,3.3,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,6.0,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,28.1,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,41.7,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,33.7,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,52.4,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,36.8,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,5.4,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,36.7,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,9.7,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,34.6,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,6.3,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,34.7,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,6.8,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,69.0,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were not stratified by multiple age groups. The rates for the survey questions include ages 18 and older and are shown within the 18 - 64 age group.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,84.4,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were not stratified by multiple age groups. The rates for the survey questions include ages 18 and older and are shown within the 18 - 64 age group.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,84.9,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were not stratified by multiple age groups. The rates for the survey questions include ages 18 and older and are shown within the 18 - 64 age group.",Yes
Alabama,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid,Administrative,1.5,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,67.4,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,73.8,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated. This measure is included in our Alabama Coordinated Healthcare Networks (ACHN) quality incentive payment structure and has received particular attention by the ACHN Networks to whom these financial incentive payments are made. This substantial rate increase is largely due to the increased effort on the part of the ACHN Network Entities.",Yes
Alabama,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,72.9,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated. This measure is included in our Alabama Coordinated Healthcare Networks (ACHN) quality incentive payment structure and has received particular attention by the ACHN Networks to whom these financial incentive payments are made. This substantial rate increase is largely due to the increased effort on the part of the ACHN Network Entities.",Yes
Alabama,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,73.6,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rates were audited or validated. This measure is included in our Alabama Coordinated Healthcare Networks (ACHN) quality incentive payment structure and has received particular attention by the ACHN Networks to whom these financial incentive payments are made. This substantial rate increase is largely due to the increased effort on the part of the ACHN Network Entities.",Yes
Alabama,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid,Administrative,70.5,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Administrative,15.3,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,31.3,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid,Administrative,117.1,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,49.7,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,6.0,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,28.0,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,4.1,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,5.6,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,37.8,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,1.1,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,8.9,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Administrative,74.8,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,37.5,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Alabama,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative,47.0,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Rate was audited or validated.",Yes
Alabama,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,12.4,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population."" Alabama Medicaid Policy stipulates that when chlamydia and gonorrhea are tested on the same date visit, the CPT Code 87801 is to be used. This code is not in the HEDIS Value Set and is not included for reporting. If this code were to be included, Alabama rates would more than double.",Yes
Alabama,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,26.7,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Since Medicare claims are unavailable, Alabama Medicaid Agency recipients who are dually enrolled in Medicaid and Medicare are excluded from the eligible population.""",Yes
Arizona,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,55.8,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,50.8,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,29.1,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,6.1,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,77.3,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,19.0,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,26.0,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,42.7,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,55.9,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.9,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,71.9,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated. Additional provider types were included within the numerator to align with the state's delivery system.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,44.6,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,13.0,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,64.8,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,34.0,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,44.8,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,11.4,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,47.9,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,18.1,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,8.8,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,51.7,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & Dual Eligibles,Administrative,58.4,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & Dual Eligibles,Administrative,62.0,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & Dual Eligibles,Administrative,59.4,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,42.2,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative & Hybrid,41.2,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rate was derived using both administrative and hybrid method data. Twelve of 14 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rate was audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative & Hybrid,53.3,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rate was derived using both administrative and hybrid method data. Eleven of 14 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rate was audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,1.0935,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,18.5,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & Dual Eligibles,Administrative,24.0,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,26.9,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,3.5,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,20.8,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,4.1,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,8.3,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,33.2,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,0.9,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,9.6,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (14 MCOs). Rates were audited or validated.,Yes
Arizona,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative & Hybrid,65.1,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rate was derived using both administrative and hybrid method data. Ten of 14 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,45.6,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arizona,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & Dual Eligibles,Administrative & Hybrid,51.5,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Supplemental data sources."" Rate was derived using both administrative and hybrid method data. Twelve of 14 MCOs calculated the measure using hybrid methodology; all MCOs were encouraged to utilize supplemental data sources, as allowable and in accordance with the associated specifications. Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Arizona,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & Dual Eligibles,Administrative,51.1,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (14 MCOs). Rate was audited or validated.,Yes
Arkansas,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Other",Administrative,54.3,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rate excludes the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,55.2,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,39.4,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,17.3,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare/Medicaid Dual Eligibles). State reported that the rate excludes the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance aid category codes and non-Medicaid aid categories."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Other",Administrative,80.7,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rate excludes the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,7.9,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, contractor excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and chemical dependency benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,11.2,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, contractor excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and chemical dependency benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Other",Administrative,23.1,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and mental health benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,34.9,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and mental health benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,19.4,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare/Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and mental health benefits. Mental Health providers in MMIS are identified by Provider Type and Specialty Codes. Mental Health providers in QHP data are identified by their organizations using a numeric or proprietary alphabetic specialty code as given through their provider files.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,36.4,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare/Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and mental health benefits. Mental Health providers in MMIS are identified by Provider Type and Specialty Codes. Mental Health providers in QHP data are identified by their organizations using a numeric or proprietary alphabetic specialty code as given through their provider files.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,45.6,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical, pharmacy, and chemical dependency (inpatient and outpatient) benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,8.0,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical, pharmacy, and chemical dependency (inpatient and outpatient) benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,54.9,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical, pharmacy, and chemical dependency (inpatient and outpatient) benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,29.2,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical, pharmacy, and chemical dependency (inpatient and outpatient) benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,43.0,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical, pharmacy, and chemical dependency (inpatient and outpatient) benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,7.5,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical, pharmacy, and chemical dependency (inpatient and outpatient) benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,43.9,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical, pharmacy, and chemical dependency (inpatient and outpatient) benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,10.2,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical, pharmacy, and chemical dependency (inpatient and outpatient) benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Other",Administrative,0.7,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" population (Arkansas Works Medicaid Expansion). State reported that the rate excludes the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and pharmacy benefits.",Yes
Arkansas,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & Other,Administrative,55.6,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rate excludes the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical and chemical dependency (inpatient, residential, and outpatient) benefits.",Yes
Arkansas,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,1.0544,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
Arkansas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Other",Administrative,20.1,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that the rate excludes the following populations: "" Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. State reported the following deviation: ""Implemented UB-04 codes only in Table PQI01-B. Admission Codes for Transfers.""",Yes
Arkansas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,"Medicaid, CHIP, & Other",Administrative,28.2,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that the rate excludes the following populations: "" Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. State reported the following deviation: ""Implemented UB-04 codes only in Table PQI05-C. Admission Codes for Transfers.""",Yes
Arkansas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Other",Administrative,22.8,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that the rate excludes the following populations: "" Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. State reported the following deviation: ""Implemented UB-04 codes only in Table PQI08-B. Admission Codes for Transfers.""",Yes
Arkansas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,"Medicaid, CHIP, & Other",Administrative,2.5,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that the rate excludes the following populations: "" Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. State reported the following deviation: ""Implemented UB-04 codes only in ""Table PQI15-B. Admission Codes for Transfers.""",Yes
Arkansas,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,83.4,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Community and Employment Support (CES) Waiver enrollees. Funding source includes a combination 1915(b)/(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 4,225. The state provided the following information about the sampling or survey methodology: Proportionate by supportive living provider.",Yes
Arkansas,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,98.9,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Community and Employment Support (CES) Waiver enrollees. Funding source includes a combination 1915(b)/(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 4,225. The state provided the following information about the sampling or survey methodology: Proportionate by supportive living provider.",Yes
Arkansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Other",Administrative,22.8,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical or family planning only services benefits. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Other",Administrative,3.2,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rates exclude the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical or family planning only services benefits. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Other",Administrative,12.0,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" population (Arkansas Works Medicaid Expansion). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical or family planning only services benefits. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Other",Administrative,37.7,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" population (Arkansas Works Medicaid Expansion). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical or family planning only services benefits. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Other",Administrative,0.6,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" population (Arkansas Works Medicaid Expansion). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical or family planning only services benefits. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Other",Administrative,8.1,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (3 MCOs). Rates also include ""other"" population (Arkansas Works Medicaid Expansion). State reported that rates exclude the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rates were audited or validated. Calculation used eligibility data and state did not verify if beneficiaries had medical or family planning only services benefits. Services in Arkansas Medicaid bill as part of maternity global billing, making it difficult to identify individual visits.",Yes
Arkansas,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,"Medicaid, CHIP, & Other",Administrative,41.7,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rate excludes the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. State implemented the optional exclusion. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
Arkansas,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Other",Administrative,43.3,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" populations (Arkansas Works Medicaid Expansion and Medicare-Medicaid Dual Eligibles). State reported that rate excludes the following populations: ""Dual eligibles identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance and non-Medicaid aid category codes."" The state described the ""other"" data sources used to calculate the measure as the following: ""Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. State implemented the optional exclusion. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
Arkansas,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,"Medicaid, CHIP, & Other",Administrative,55.5,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (3 MCOs). Rate also includes ""other"" population (Arkansas Works Medicaid Expansion). State reported that the rate excludes the following populations: ""Medicare/Medicaid dual eligible beneficiaries identified in the measurement year. For continuous enrollment exclusions, calculation excluded eligibility segments for Medicare Assistance aid category codes and non-Medicaid aid categories."" The state described the ""other"" data sources used to calculate the measure as the following: ""a. Qualified Health Plans (QHP) provider and claims data."" Rate was audited or validated. State implemented the optional exclusion. Calculation used eligibility data and state did not verify if beneficiaries had medical benefits.",Yes
California,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,62.7,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,64.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed Care plan administrative data."" Rates are provisional. Rates were audited or validated. State did not select ""Denominator includes Medicare and Medicaid Dually-Eligible Population"" due to incomplete data - no Medicare Part C.",Yes
California,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,47.2,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed Care plan administrative data."" Rates are provisional. Rates were audited or validated. State did not select ""Denominator includes Medicare and Medicaid Dually-Eligible Population"" due to incomplete data - no Medicare Part C.",Yes
California,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,9.1,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,79.8,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed Care plan administrative data."" Rate is provisional. Rate was audited or validated.",Yes
California,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,8.5,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,15.5,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,45.6,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,57.9,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,65.2,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,74.6,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,32.3,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,8.1,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,48.4,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,16.9,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,35.5,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,8.6,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,35.7,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,9.4,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,3.5,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,60.5,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,59.3,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,61.8,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,60.1,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,36.7,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (25 MCOs). State reported that the rate excludes the following populations: ""About 9% of Medicaid population which was not in a managed care plan 11 out of 12 months."" The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan data for Kaiser North and South, which report administratively."" Denominator is the sample size; measure-eligible population is 491,832. Rate was audited or validated.",Yes
California,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Hybrid,57.5,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan data for Kaiser North and South, which report administratively."" Rate was derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rate is provisional. Rate was audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.",Yes
California,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,0.9758,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (25 MCOs). Rates are provisional. Rates were audited or validated.,Yes
California,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,13.0,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,2.1,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated.,Yes
California,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,24.1,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,4.6,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,10.5,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,33.4,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,2.5,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,9.9,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rates are provisional. Rates were audited or validated.",Yes
California,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Administrative & Hybrid,76.8,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan for Kaiser North and South which reported administratively."" Rate was derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rate is provisional. Rate was audited or validated.",Yes
California,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,58.7,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (25 MCOs). Rate is provisional. Rate was audited or validated. The state did not include Medicare and Medicaid Dually-Eligible population due to incomplete data - no Medicare Part C.,Yes
California,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Administrative & Hybrid,54.7,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plans including Kaiser North and South, Health Plan of San Joaquin, and Health Net Community Solutions (Kern County) reported administratively."" Rate was derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rate is provisional. Rate was audited or validated.",Yes
California,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,67.4,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (25 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care plan administrative data."" Rate is provisional. Rate was audited or validated.",Yes
Colorado,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,62.7,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and FFS populations.,Yes
Colorado,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,66.7,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,45.1,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,14.9,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,78.1,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,15.3,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,21.1,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & Dual Eligibles,Administrative,26.5,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,36.3,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,34.0,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,50.0,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,41.0,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,6.3,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,54.4,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,14.0,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,40.4,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,3.7,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,42.2,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,6.4,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,4.1,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs).,Yes
Colorado,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,52.7,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs).,Yes
Colorado,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,44.8,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,50.3,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,46.1,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,69.0,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,36.8,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs).,Yes
Colorado,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & Dual Eligibles,Administrative,258.8,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs).,Yes
Colorado,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,6.7,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs).,Yes
Colorado,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,89.5,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Developmental Disabilities Waiver and Supported Living Services Waiver enrollees. Funding sources include 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 11,665. The state provided the following information about the sampling or survey methodology: Proportionate sample by waiver program and Regional Accountable Entities (RAEs) (Regions 1-7).",Yes
Colorado,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,96.7,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Developmental Disabilities Waiver and Supported Living Services Waiver enrollees. Funding sources include 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 11,665. The state provided the following information about the sampling or survey methodology: Proportionate sample by waiver program and Regional Accountable Entities (RAEs) (Regions 1-7).",Yes
Colorado,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,19.6,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,4.8,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,8.7,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,30.6,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,1.7,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,12.0,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Administrative,46.9,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,36.9,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative,35.8,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (2 MCOs).",Yes
Colorado,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,55.5,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (2 MCOs).",Yes
Connecticut,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,64.7,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. Rate was audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,64.6,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,47.4,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,2.2,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. Rate was audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,75.8,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. Rate was audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,17.5,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,30.5,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,42.1,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,56.4,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,45.2,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,64.9,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,40.6,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,17.7,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,50.9,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,32.6,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,38.5,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,18.3,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,41.1,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,20.4,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,87.6,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,60.7,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,48.1,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,9.1,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,77.2,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,64.2,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,66.9,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,65.1,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,38.9,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,36.8,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. Denominator is the sample size; measure-eligible population is 41,147. Rate was audited or validated.",Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,63.9,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. Denominator is the sample size; measure-eligible population is 52,377. Rate was audited or validated.",Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,1.2393,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population. Rates were audited or validated.,Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,13.6,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & CHIP,Administrative,29.7,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,15.2,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,4.9,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Connecticut,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,90.6,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Comprehensive Waiver, Individual and Family Supports Waiver, and Employment and Day Supports Waiver enrollees. Funding sources include 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 10,595. The state provided the following information about the sampling or survey methodology: Stratified by case manager.",Yes
Connecticut,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,91.8,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Comprehensive Waiver, Individual and Family Supports Waiver, and Employment and Day Supports Waiver enrollees. Funding sources include 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 10,595. The state provided the following information about the sampling or survey methodology: Stratified by case manager.",Yes
Connecticut,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,26.8,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,4.5,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,15.5,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,41.3,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,5.7,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,13.2,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Connecticut,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,82.5,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. Denominator is the sample size; measure-eligible population is 11,407. Rate was audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,55.8,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. Rate was audited or validated.,Yes
Connecticut,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Hybrid,62.5,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. Denominator is the sample size; measure-eligible population is 207,005. Rate was audited or validated.",Yes
Connecticut,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,70.1,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population. Rate was audited or validated.,Yes
Connecticut,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,47.3,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Delaware,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & Dual Eligibles,Administrative,60.9,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,56.9,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee for Service population is excluded, data source not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,40.8,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee for Service population is excluded, data source not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,10.7,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,70.1,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,11.0,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,20.9,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & Dual Eligibles,Administrative,30.2,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claim Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,41.8,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claim Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,28.8,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,45.9,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,45.5,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,15.4,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,62.3,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,39.1,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,44.4,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,13.7,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,49.0,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,23.0,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,72.1,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,50.3,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,47.8,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Rates were audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,7.1,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,65.5,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & Dual Eligibles,Administrative,54.6,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, data source not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management Systems."" Rates were audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & Dual Eligibles,Administrative,58.7,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, data source not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management Systems."" Rates were audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & Dual Eligibles,Administrative,55.8,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, data source not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management Systems."" Rates were audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & Dual Eligibles,Hybrid,39.7,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee for Service population is excluded, data source not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Sample size is 822; measure-eligible population is 9,294. Rate was audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Hybrid,58.8,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 13,983. Rate was audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,1.1785,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,21.8,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,89.1,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Lifespan Waiver, State Plan, and State Funding enrollees. Funding sources include a 1915(c) waiver, state plan, and state funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 3,000. The state provided the following information about the sampling or survey methodology: Proportionate by county and by case management type.",Yes
Delaware,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,91.2,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Lifespan Waiver, State Plan, and State Funding enrollees. Funding sources include a 1915(c) waiver, state plan, and state funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 3,000. The state provided the following information about the sampling or survey methodology: Proportionate by county and by case management type.",Yes
Delaware,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,24.4,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,4.0,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,23.5,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-for-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,48.2,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-for-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,9.6,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-for-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,17.3,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). State reported that rates exclude the following populations: ""The Fee-for-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rates were audited or validated.",Yes
Delaware,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,79.3,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee- for- Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Denominator is the sample size; measure-eligible population is 3,387. Rate was audited or validated. One MCO reduced its sample size to 270 based on the prior year medical record review results, as allowed by the NCQA HEDIS measurement year 2021 General Guidelines.",Yes
Delaware,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,51.1,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, data source not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management System."" Rate was audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Hybrid,51.3,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management Systems."" Denominator is the sample size; measure-eligible population is 47,983. Rate was audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,67.5,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Management Systems."" Rate was audited or validated.",Yes
Delaware,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,39.9,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). State reported that the rate excludes the following populations: ""The Fee-For-Service population is excluded, as the data source is not easily accessible."" Rate was audited or validated.",Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,45.1,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,52.9,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,35.0,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,11.5,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (4 MCOs). Rate was audited or validated.,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,70.3,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,6.3,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,10.5,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.4,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,65.2,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.1,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,68.5,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,49.2,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,6.1,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,50.1,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,13.2,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,46.5,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,4.8,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,46.1,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,5.6,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs).,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,72.6,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure.""",Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,47.5,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure.""",Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,45.2,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure.""",Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,4.5,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (4 MCOs). Rate was audited or validated.,Yes
Dist. of Col.,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,39.4,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rate was audited or validated.",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,53.8,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,51.6,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,53.1,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,72.2,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,47.4,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 10,062. Rate was audited or validated.",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,42.8,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 13,641.",Yes
Dist. of Col.,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,1.1831,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,18.7,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,2.8,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,12.6,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,34.1,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,2.9,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,9.6,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). State reported that rates exclude the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Rates were audited or validated.",Yes
Dist. of Col.,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,71.0,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 2,557. Rate was audited or validated.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,57.8,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available to report."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" DC has one MCP that serves ages 0-26 and thus is not included in this measure.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Hybrid,45.6,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population (ages 18-64) were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems."" Denominator is the sample size; measure-eligible population is 59,733.",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,76.0,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). State reported that the rate excludes the following populations: ""The FFS population is excluded from this measure. Only data on the managed care population were available for this measure."" The state described the ""other"" data sources used to calculate the measure as the following: ""DHCF reports this measure using MCO data only. The source of administrative data is the MCO data systems.""",Yes
Dist. of Col.,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & CHIP,CAHPS 5.1H,44.3,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""The FFS population and one health plan which did not report data for this measure are excluded. Only data on the managed care population (ages 18-64) were available for this measure.""",Yes
Florida,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,60.4,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated.",Yes
Florida,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,60.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data reported by the health plans."" Rates were audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,42.3,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data reported by the health plans."" Rates were audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,20.8,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,77.9,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated.",Yes
Florida,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,6.4,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,9.7,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,23.8,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,35.9,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,19.2,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,34.0,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,45.5,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18-64 categories include ages 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,6.3,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18-64 categories include ages 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,48.8,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18-64 categories include ages 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,12.6,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18-64 categories include ages 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,40.0,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18-64 categories include ages 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,4.7,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18-64 categories include ages 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,41.7,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18-64 categories include ages 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,6.7,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated. The Ages 18-64 categories include ages 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,72.5,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (11 MCOs). Rates were audited or validated.,Yes
Florida,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,49.9,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (11 MCOs). Rates were audited or validated.,Yes
Florida,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,43.6,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (11 MCOs). Rates were audited or validated.,Yes
Florida,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid,Administrative,13.5,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated. The Ages 18-64 category includes ages 18 and older.",Yes
Florida,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,49.5,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated.",Yes
Florida,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,58.7,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,55.4,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,57.8,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Administrative & Hybrid,48.9,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was derived using both administrative and hybrid method data. The measure-eligible population is 92,842. Rate was audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Florida,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Administrative & Hybrid,58.2,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was derived using both administrative and hybrid method data. Thirteen plans reported using the hybrid methodology and 2 plans reported using the administrative methodology. The measure-eligible population is 134,153. Rate was audited or validated. The Ages 18 to 64 rate includes individuals ages 18-85.",Yes
Florida,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,1.0148,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,92.4,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include iBudget Waiver and Consumer Directed Care Plus (CDC+) Program enrollees. Funding sources include a 1915(c) waiver and a 1915(j) state plan option. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 32,209. The state provided the following information about the sampling or survey methodology: Stratified by Waiver Support Coordinator (WSC).",Yes
Florida,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,81.7,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include iBudget Waiver and Consumer Directed Care Plus (CDC+) Program enrollees. Funding sources include a 1915(c) waiver and a 1915(j) state plan option. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 32,209. The state provided the following information about the sampling or survey methodology: Stratified by Waiver Support Coordinator (WSC).",Yes
Florida,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,20.4,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,3.6,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (15 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,10.3,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (13 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,32.6,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (13 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,0.8,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (13 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,6.6,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (13 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rates were audited or validated.",Yes
Florida,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,70.4,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Denominator is the sample size; measure-eligible population is 83,699. Rate was audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,48.6,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (13 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated. The Ages 50 to 64 rate includes individuals ages 50-74.",Yes
Florida,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative & Hybrid,55.2,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (13 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was derived using both administrative and hybrid method data. Twelve plans reported using the hybrid methodology and 1 plan reported using the administrative methodology The measure-eligible population is 532,050. Rate was audited or validated.",Yes
Florida,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,64.9,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by the health plans."" Rate was audited or validated.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,37.3,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment."" Rate was audited or validated.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,55.1,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""Data may include small number of dually eligible population."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Population may include a very small, or no denominator for 65 and older age group; no reported numerator.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,37.3,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""Data may include small number of dually eligible population."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Population may include a very small, or no denominator for 65 and older age group; no reported numerator.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Other",Administrative,77.8,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""denominator may include small number of dually eligible members."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rate was audited or validated.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,8.5,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. The numerator and denominator for follow-up within 30 days of ED visit ages 18-64 may include small number of 65+ population. The numerator and denominator for follow-up within 7 days of ED visit ages 18-64 may include a small number of the 65+ population.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,11.2,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. The numerator and denominator for follow-up within 30 days of ED visit ages 18-64 may include small number of 65+ population. The numerator and denominator for follow-up within 7 days of ED visit ages 18-64 may include a small number of the 65+ population.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Other",Administrative,24.2,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""may include small number of Medicare and Medicaid dually eligible population."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,34.0,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""may include small number of Medicare and Medicaid dually eligible population."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,31.5,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,49.1,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rates were audited or validated.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,42.2,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""population may contain small number of dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Numerator and denominator for Ages 18 to 64 may include a small number of the 65+ population.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,8.5,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""population may contain small number of dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Numerator and denominator for Ages 18 to 64 may include a small number of the 65+ population.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,56.6,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""population may contain small number of dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Numerator and denominator for Ages 18 to 64 may include a small number of the 65+ population.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,24.2,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""population may contain small number of dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Numerator and denominator for Ages 18 to 64 may include a small number of the 65+ population.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,43.2,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""population may contain small number of dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Numerator and denominator for Ages 18 to 64 may include a small number of the 65+ population.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,7.7,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""population may contain small number of dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Numerator and denominator for Ages 18 to 64 may include a small number of the 65+ population.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,43.8,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""population may contain small number of dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Numerator and denominator for Ages 18 to 64 may include a small number of the 65+ population.",Yes
Georgia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,10.2,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""population may contain small number of dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated. Numerator and denominator for Ages 18 to 64 may include a small number of the 65+ population.",Yes
Georgia,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,55.4,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,58.0,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,55.6,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rates were audited or validated.",Yes
Georgia,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Hybrid,56.4,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""may include very small number of Medicare/Medicaid dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment and medical record review data."" Sample size is 1,233; measure-eligible population is 16,666. Rate was audited or validated. Numerator and Denominator for Ages 18 to 64 may include a small number of 65+ population.",Yes
Georgia,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Hybrid,47.0,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""Denominator may include small number of dually eligible population."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data. Calculation of the statewide/weighted averages is based on the CMO's audited HEDIS and non-HEDIS data."" Sample size is 1,233; measure-eligible population is 27,686. Rate was audited or validated. Numerator and denominator for ages 18-64 may include 65-85 population.",Yes
Georgia,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Administrative,0.9516,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" population included in the measure as the following: ""may include very small number of dually eligible."" The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from CMO Interactive Data Submission System (IDSS) submissions as well as performance measure rates from audits that the EQRO conducts for CMOs, based on CMOS' claims-encounters, supplemental and enrollment data."" Rates were audited or validated.",Yes
Georgia,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.5,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment data."" Rate was audited or validated.",Yes
Georgia,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,97.1,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Comprehensive Supports Waiver (COMP), New Options Waiver (NOW), and State Funded Services (SFS) enrollees. Funding sources include 1915(c) waivers and state funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 9,503. The state provided the following information about the sampling or survey methodology: Proportionate by region. People receiving services in an intermediate care facility (ICF) are excluded from this sample.",Yes
Georgia,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,95.6,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Comprehensive Supports Waiver (COMP), New Options Waiver (NOW), and State Funded Services (SFS) enrollees. Funding sources include 1915(c) waivers and state funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 9,503. The state provided the following information about the sampling or survey methodology: Proportionate by region. People receiving services in an intermediate care facility (ICF) are excluded from this sample.",Yes
Georgia,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,66.4,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Sample size is 1,233; measure-eligible population is 51,994. Rate was audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,47.8,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rate was audited or validated. Numerator and denominator for ages 50-64 may include ages 65-74 population.",Yes
Georgia,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Hybrid,61.1,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, enrollment, and medical record data."" Sample size is 1,188; measure-eligible population is 231,175. Rate was audited or validated.",Yes
Georgia,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,64.1,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""The state's EQRO uses the data from the care management organizations' (CMOs') audited Interactive Data Submission System (IDSS) submissions as well as the performance measure rates from the performance measure validation (PMV) audits that the EQRO conducts for the CMOs, which is based on the CMOs' claims/encounter, supplemental, and enrollment data."" Rate was audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,69.3,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,59.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,42.2,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,13.2,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,68.8,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,18.2,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,25.8,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,30.2,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,46.5,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,38.9,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,59.2,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,34.5,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,10.4,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,41.3,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.9,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,39.0,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,11.8,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,37.2,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,11.6,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,10.7,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,50.4,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rate was audited or validated.",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,57.8,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan.""",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,61.9,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan.""",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,59.4,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan.""",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative & Hybrid,39.8,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan."" Rate was derived using both administrative and hybrid method data. One health plan used administrative method and four health plans used hybrid method. The measure-eligible population is 23,741.",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,55.0,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). Sample size is 4,032; measure-eligible population is 33,431. Rate was audited or validated.",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,0.8626,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rates were audited or validated.",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,8.6,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,13.4,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,36.2,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rate was audited or validated.",Yes
Hawaii,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,2.6,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,23.9,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,5.3,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,9.3,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (5 MCOs).,Yes
Hawaii,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,41.8,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (5 MCOs).,Yes
Hawaii,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,2.8,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (5 MCOs).,Yes
Hawaii,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,15.0,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (5 MCOs).,Yes
Hawaii,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,77.6,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rate was audited or validated.",Yes
Hawaii,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.6,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Hawaii,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative & Hybrid,55.8,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans."" Rate was derived using both administrative and hybrid method data. One health plan used administrative method and four health plans used hybrid method. The measure-eligible population is 93,679. Rate was audited or validated.",Yes
Hawaii,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,53.8,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans.""",Yes
Idaho,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,78.2,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.5,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,76.0,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,31.3,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,39.2,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,61.9,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,74.1,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,32.1,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,48.9,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,46.3,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,23.5,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,56.2,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,37.4,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,45.3,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,28.6,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,47.3,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,28.2,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,2.1,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,58.1,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,57.6,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,57.9,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,12.4,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,2.2,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,22.7,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,5.8,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,6.3,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,39.6,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,0.3,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.6,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations. Rates are provisional.,Yes
Idaho,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,35.8,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Idaho,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,32.5,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations. Rate is provisional.,Yes
Illinois,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,96.5,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Adult HCBS Waiver enrollees. Funding source includes a 1915(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 21,919. The state provided the following information about the sampling or survey methodology: Simple random sample. Individuals who live at state operated developmental centers or intermediate care facilities are excluded from this sample.",Yes
Illinois,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,97.0,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Adult HCBS Waiver enrollees. Funding source includes a 1915(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 21,919. The state provided the following information about the sampling or survey methodology: Simple random sample. Individuals who live at state operated developmental centers or intermediate care facilities are excluded from this sample.",Yes
Indiana,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,90.2,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Community Integration and Habilitation Waiver (CIH), Family Supports Waiver (FSW), and Supervised Group Living (SGL) enrollees. Funding sources include 1915(c) waivers and ICF/IID funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 26,721. The state provided the following information about the sampling or survey methodology: Stratified sample by waiver and by region.",Yes
Indiana,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,95.3,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Community Integration and Habilitation Waiver (CIH), Family Supports Waiver (FSW), and Supervised Group Living (SGL) enrollees. Funding sources include 1915(c) waivers and ICF/IID funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 26,721. The state provided the following information about the sampling or survey methodology: Stratified sample by waiver and by region.",Yes
Iowa,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,72.9,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,52.8,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,31.4,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,13.5,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,76.4,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,54.3,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,59.8,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,40.4,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,55.9,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,38.8,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,57.4,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,45.0,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,13.0,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,52.2,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,26.9,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,44.7,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,13.9,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,45.6,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,14.6,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,"Medicaid, CHIP, Dual Eligibles, & Other",CAHPS 5.1H,57.8,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). The state described the ""other"" population included in the measure as the following: ""Survey sample included beneficiaries who were 18 years and older (as of December 31st of the measurement year) and continuously enrolled in the plan for at least five of the last 6 months of the measurement year.""",Yes
Iowa,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,"Medicaid, CHIP, Dual Eligibles, & Other",CAHPS 5.1H,48.4,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). The state described the ""other"" population included in the measure as the following: ""Survey sample included beneficiaries who were 18 years and older (as of December 31st of the measurement year) and continuously enrolled in the plan for at least five of the last 6 months of the measurement year.""",Yes
Iowa,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,"Medicaid, CHIP, Dual Eligibles, & Other",CAHPS 5.1H,44.9,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). The state described the ""other"" population included in the measure as the following: ""Survey sample included beneficiaries who were 18 years and older (as of December 31st of the measurement year) and continuously enrolled in the plan for at least five of the last 6 months of the measurement year.""",Yes
Iowa,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,10.2,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,52.4,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,38.7,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,30.4,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,35.7,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,62.8,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,0.9646,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,20.0,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & CHIP,Administrative,62.1,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,35.0,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,3.8,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,21.3,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,2.7,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,12.5,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,36.6,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,3.0,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,11.5,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,50.8,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Administrative,46.9,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,48.1,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (2 MCOs).,Yes
Iowa,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,"Medicaid, CHIP, Dual Eligibles, & Other",CAHPS 5.1H,45.4,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). The state described the ""other"" population included in the measure as the following: ""Survey sample included beneficiaries who were 18 years and older (as of December 31st of the measurement year) and continuously enrolled in the plan for at least five of the last 6 months of the measurement year.""",Yes
Kansas,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & Dual Eligibles,Administrative,58.2,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative & Electronic Health Records,53.6,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated. Kansas does not stratify by age; the 18 to 64 rates include all adults 18 and older.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative & Electronic Health Records,37.6,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated. Kansas does not stratify by age; the 18 to 64 rates include all adults 18 and older.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,16.3,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,78.5,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,13.6,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated. Kansas does not stratify by age; the ages 18 to 64 rates include adults 18 and older.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,20.2,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated. Kansas does not stratify by age; the ages 18 to 64 rates include adults 18 and older.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & Dual Eligibles,Administrative,62.9,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,75.1,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,43.8,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,65.9,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,43.3,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO data."" Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.",Yes
Kansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,10.9,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO data."" Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.",Yes
Kansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,39.3,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO data."" Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.",Yes
Kansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,11.7,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO data."" Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.",Yes
Kansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,41.5,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO data."" Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.",Yes
Kansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,11.8,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO data."" Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.",Yes
Kansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,41.1,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO data."" Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.",Yes
Kansas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,12.1,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO data."" Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.",Yes
Kansas,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,87.5,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,49.9,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,43.7,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated. Kansas does not stratify by age.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,6.2,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate is provisional. Rate was audited or validated. Kansas does not stratify by age.,Yes
Kansas,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,27.3,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,56.9,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,57.2,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,57.0,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,45.8,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""clinical data."" Rate is provisional. Rate was audited or validated.",Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative & Hybrid,41.7,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). Rate was derived using both administrative and hybrid method data. The measure-eligible population is 16,446. Rate is provisional. Rate was audited or validated. Kansas does not stratify by age for this measure.",Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,61.2,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated. Kansas does not stratify by age.,Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,0.9726,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,24.0,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & Dual Eligibles,Administrative,59.3,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,54.7,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & Dual Eligibles,Administrative,1.6,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,94.4,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Intellectual/Developmental Disability (I/DD) Waiver enrollees. Funding source includes a 1915(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 8,200. The state provided the following information about the sampling or survey methodology: Proportionate sample by Community Developmental Disability Organization (CDDO).",Yes
Kansas,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,93.8,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Intellectual/Developmental Disability (I/DD) Waiver enrollees. Funding source includes a 1915(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 8,200. The state provided the following information about the sampling or survey methodology: Proportionate sample by Community Developmental Disability Organization (CDDO).",Yes
Kansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,27.5,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,6.3,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,10.2,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,38.4,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,1.2,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,12.3,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Rates are provisional. Rates were audited or validated.,Yes
Kansas,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & Dual Eligibles,Hybrid,75.1,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). Sample size is 4,905; measure-eligible population is 11,373. Rate is provisional. Rate was audited or validated.",Yes
Kansas,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,45.2,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated. Kansas does not stratify by age.,Yes
Kansas,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,60.8,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & Dual Eligibles,Administrative,53.8,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kansas,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,37.8,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Rate is provisional. Rate was audited or validated.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,60.7,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate was audited or validated.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,61.8,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The above numerators include individuals ages 18 years and older.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,44.2,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The above numerators include individuals ages 18 years and older.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,82.4,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate was audited or validated.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.6,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rates include individuals ages 18 years and over.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,25.4,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rates include individuals ages 18 years and over.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,30.0,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,43.2,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,30.9,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,52.1,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,45.4,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rate includes individuals ages 18 years and over.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.0,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rate includes individuals ages 18 years and over.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,71.7,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rate includes individuals ages 18 years and over.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,47.9,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rate includes individuals ages 18 years and over.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,44.8,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rate includes individuals ages 18 years and over.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.9,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rate includes individuals ages 18 years and over.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,52.1,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rate includes individuals ages 18 years and over.,Yes
Kentucky,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,24.7,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated. The rate includes individuals ages 18 years and over.,Yes
Kentucky,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.0,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.1,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.0,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,32.8,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate was audited or validated.,Yes
Kentucky,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,57.8,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rate was audited or validated. The rate includes individuals ages 18-85.,Yes
Kentucky,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,0.9655,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (6 MCOs). Rates were audited or validated.,Yes
Kentucky,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,97.9,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Supports for Community Living (SCL) Waiver and the Michelle P Waiver enrollees. Funding sources include 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 10,876. The state provided the following information about the sampling or survey methodology: Proportionate by waiver/program. A small number of adults considered to have the most severe disabilities are excluded from this sample.",Yes
Kentucky,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,73.4,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Supports for Community Living (SCL) Waiver and the Michelle P Waiver enrollees. Funding sources include 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 10,876. The state provided the following information about the sampling or survey methodology: Proportionate by waiver/program. A small number of adults considered to have the most severe disabilities are excluded from this sample.",Yes
Kentucky,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,75.6,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Sample size and measure-eligible population are not available.,Yes
Kentucky,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,45.7,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate was audited or validated. The data reported includes all ages.,Yes
Kentucky,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,53.0,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Sample size and measure-eligible population are not available. Rate was audited or validated.,Yes
Kentucky,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,58.6,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate was audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,54.1,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,55.2,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,37.5,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,10.2,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,81.8,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,8.9,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,14.1,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,15.7,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,27.8,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,15.0,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,31.9,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,50.0,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,15.9,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,68.6,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,35.6,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,50.4,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,16.1,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,50.7,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,18.0,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,72.6,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,46.5,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,41.4,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,1.3,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,69.0,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,68.6,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,64.6,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,67.5,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,31.6,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Hybrid,44.3,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). Rate was derived using both administrative and hybrid method data. The measure-eligible population is 73,454. Rate was audited or validated.",Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,54.7,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 138,560. Rate was audited or validated.",Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,0.8998,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,18.7,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & CHIP,Administrative,23.2,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,28.7,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,1.7,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,25.9,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,3.4,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,12.2,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,43.9,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,2.5,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,10.5,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
Louisiana,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,74.3,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 31,813. Rate was audited or validated.",Yes
Louisiana,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,54.0,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Hybrid,58.2,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 396,009. Rate was audited or validated.",Yes
Louisiana,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,65.7,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
Louisiana,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & CHIP,CAHPS 5.1H,34.3,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (5 MCOs). Rate was audited or validated.,Yes
Maine,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,58.9,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,68.5,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,43.8,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,18.8,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Anchor dates are not used.",Yes
Maine,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,71.4,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,26.1,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims.",Yes
Maine,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,37.1,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims.",Yes
Maine,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & Dual Eligibles,Administrative,77.4,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims.",Yes
Maine,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,84.4,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims.",Yes
Maine,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,39.2,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims.",Yes
Maine,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,59.3,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims.",Yes
Maine,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,33.7,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,13.0,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,NR,43,56.6,50.1,64.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",No
Maine,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,NR,43,29.5,17.5,37.4,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",No
Maine,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,NR,43,41.3,36.9,44.8,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",No
Maine,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,NR,43,11.0,7.9,15.1,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",No
Maine,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,NR,44,43.4,41.0,47.7,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",No
Maine,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,NR,44,15.8,10.5,18.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",No
Maine,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,10.2,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Anchor dates are not used.",Yes
Maine,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,77.7,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims.""",Yes
Maine,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,67.0,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,66.9,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,67.0,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,58.1,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims.",Yes
Maine,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,1.2867,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Anchor dates are not used.",Yes
Maine,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,12.8,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims.""",Yes
Maine,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & Dual Eligibles,Administrative,18.2,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims.""",Yes
Maine,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,15.3,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims.""",Yes
Maine,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,1.6,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims.""",Yes
Maine,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,25.1,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,19.4,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,11.4,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,41.6,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,2.1,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,15.0,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,49.0,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative,46.5,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maine,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,46.7,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS population. The state described the ""other"" data sources used to calculate the measure as the following: ""claims."" Only paid claims are used as measures engine only includes paid claims. Anchor dates are not used.",Yes
Maryland,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,62.8,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,68.2,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,20.5,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,31.2,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,29.9,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,49.5,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,39.1,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,66.2,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,39.2,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,17.3,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,61.4,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,42.6,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,35.9,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,14.1,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,42.7,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,22.3,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,74.4,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,48.7,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,44.2,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,7.9,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (9 MCOs).,Yes
Maryland,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,74.8,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,61.4,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). State reported that rates exclude the following populations: ""The Medicare and Medicaid Dually-Eligible Population are carved out of managed care."" Rates were audited or validated.",Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,64.9,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). State reported that rates exclude the following populations: ""The Medicare and Medicaid Dually-Eligible Population are carved out of managed care."" Rates were audited or validated.",Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,62.4,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (9 MCOs). State reported that rates exclude the following populations: ""The Medicare and Medicaid Dually-Eligible Population are carved out of managed care."" Rates were audited or validated.",Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid,Administrative,41.4,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (9 MCOs). State reported that the rate excludes the following populations: ""Medicare and Medicaid Dually Eligible are carved out of managed care."" Rate was audited or validated.",Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,"Medicaid, CHIP, & Other",Hybrid,34.6,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (9 MCOs). State reported that the rate excludes the following populations: ""The Medicare and Medicaid Dually-Eligible Population are carved out of managed care."" The state implemented optional exclusions for members without a diagnosis, members with gestational diabetes, and members with steroid-induced diabetes. Sample size is not available; measure-eligible population is 56,863. Rate was audited or validated.",Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,58.8,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (9 MCOs). State reported that the rate excludes the following populations: ""The Medicare and Medicaid Dually-Eligible Population are carved out of managed care."" Sample size is not available; measure-eligible population is 91,931. Rate was audited or validated.",Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,0.9752,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (9 MCOs). Rates were audited or validated.,Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.1,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,26.1,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,15.4,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,Yes
Maryland,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,3.5,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (9 MCOs).,Yes
Maryland,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,83.2,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (9 MCOs). Denominator is the sample size; measure-eligible population is 21,863. Rate was audited or validated.",Yes
Maryland,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,63.4,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (9 MCOs). State reported that the rate excludes the following populations: ""The Medicare and Medicaid Dually-Eligible Population are carved out of managed care."" Rate was audited or validated.",Yes
Maryland,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Hybrid,58.8,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). Denominator is the sample size; measure-eligible population is 323,078. Rate was audited or validated. Jai Medical Services was not included due to reporting the measure administratively.",Yes
Maryland,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,67.2,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (9 MCOs). Rate was audited or validated.,Yes
Maryland,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & CHIP,CAHPS 5.1H,43.2,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (9 MCOs).,Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,69.4,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rate was audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,62.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,46.1,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,3.6,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,77.7,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs). Rate was audited or validated.,Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,21.3,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,32.0,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & Dual Eligibles,Administrative,74.5,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,80.4,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,43.3,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,66.0,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,45.6,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,14.0,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,65.3,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,33.0,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,40.4,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,9.3,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,46.7,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,16.7,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,74.3,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (15 MCOs).,Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,57.7,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (15 MCOs).,Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,49.9,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (15 MCOs).,Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,7.5,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes PCCM, integrated care management (ICM) and managed care populations (15 MCOs).",Yes
Massachusetts,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,78.9,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,51.2,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,55.6,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,52.6,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include PCCM and managed care populations (15 MCOs). Rates were audited or validated.,Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,57.2,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rate was audited or validated.",Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & Dual Eligibles,Hybrid,39.1,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Hybrid,64.4,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,1.1803,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rates were audited or validated.",Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,12.0,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid,Administrative,33.0,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,16.5,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,4.2,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Massachusetts,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,93.7,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Intensive Supports Waiver, Community Living Waiver, and Adult Supports Waiver enrollees. Funding sources include 1915(c) waivers and state funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 20,015. The state provided the following information about the sampling or survey methodology: Proportionate by region.",Yes
Massachusetts,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,96.7,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Intensive Supports Waiver, Community Living Waiver, and Adult Supports Waiver enrollees. Funding sources include 1915(c) waivers and state funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 20,015. The state provided the following information about the sampling or survey methodology: Proportionate by region.",Yes
Massachusetts,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.9,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,4.8,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.5,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,45.5,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,4.3,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.3,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, integrated care management (ICM), and managed care populations (15 MCOs).",Yes
Massachusetts,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,81.1,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rate was audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,60.2,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes PCCM, integrated care management (ICM) and managed care populations (15 MCOs). Rate was audited or validated.",Yes
Massachusetts,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Hybrid,65.3,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs). Denominator is the measure-eligible population. Rate was audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,68.8,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs). Rate was audited or validated.,Yes
Massachusetts,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,47.4,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes PCCM and managed care populations (15 MCOs).,Yes
Michigan,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,58.3,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,56.2,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,34.3,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,15.3,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,76.3,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,14.9,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,23.8,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,41.6,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains a copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,55.6,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains a copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,43.4,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse (contains a copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,64.4,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of Michigan Data Warehouse (contains a copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,38.7,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,9.1,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,51.4,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,25.7,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,34.8,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,6.5,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,38.8,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,11.1,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid,Administrative,3.0,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,52.1,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,53.9,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,52.5,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,21.9,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid,Administrative,40.6,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,26.6,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,4.9,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,93.8,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include a 1915(c) and 1115/1915(i) enrollees. Funding sources include a 1915(c) waiver and a combination 1115 demonstration/1915(i) state plan option. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 27,597. The state provided the following information about the sampling or survey methodology: Simple random sample.",Yes
Michigan,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,89.8,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include a 1915(c) and 1115/1915(i) enrollees. Funding sources include a 1915(c) waiver and a combination 1115 demonstration/1915(i) state plan option. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 27,597. The state provided the following information about the sampling or survey methodology: Simple random sample.",Yes
Michigan,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,22.7,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,3.5,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,11.6,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,35.6,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,1.3,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,7.8,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Administrative,65.0,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,51.5,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative,41.4,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Michigan,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,63.5,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (9 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State of MI Data Warehouse (contains copy of MMIS data).""",Yes
Minnesota,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,80.7,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Rate includes paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,69.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,55.1,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.6,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Rate includes paid claims only.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,75.5,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Rate includes paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,18.2,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,27.5,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,48.4,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,62.7,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,32.6,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,59.5,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,40.4,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.1,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,53.3,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,24.0,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,40.4,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,15.1,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,41.6,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.3,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,73.9,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs).,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,58.2,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs).,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,49.3,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs).,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,7.1,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Rate includes paid claims only.,Yes
Minnesota,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,53.2,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Rate includes paid claims only.,Yes
Minnesota,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,57.1,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,60.7,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,58.1,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,0.8651,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid and denied claims.,Yes
Minnesota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,15.0,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs).,Yes
Minnesota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,20.0,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs).,Yes
Minnesota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,19.8,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs).,Yes
Minnesota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,2.4,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs).,Yes
Minnesota,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,90.7,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Developmental Disabilities (DD Waiver) enrollees. Funding source includes a 1915(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 22,427. The state provided the following information about the sampling or survey methodology: Simple random sample.",Yes
Minnesota,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,94.7,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Developmental Disabilities (DD Waiver) enrollees. Funding source includes a 1915(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 22,427. The state provided the following information about the sampling or survey methodology: Simple random sample.",Yes
Minnesota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,26.2,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,5.8,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,8.2,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,35.2,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,1.0,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,12.7,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (8 MCOs). Rates include paid claims only.,Yes
Minnesota,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,51.1,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Rate includes paid and denied claims.,Yes
Minnesota,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,53.6,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Rate includes paid and denied claims.,Yes
Minnesota,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,53.4,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Rate includes paid and denied claims.,Yes
Minnesota,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.6,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs). Rate includes paid and denied claims.,Yes
Minnesota,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,47.3,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (8 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,56.8,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,53.5,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,36.3,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,4.0,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,70.5,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,4.0,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,6.8,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,28.4,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,42.5,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,30.5,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,54.4,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,41.3,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,4.8,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,39.2,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,16.3,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,38.7,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,5.2,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,38.7,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,5.2,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid,Administrative,1.4,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Mississippi,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,57.6,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,48.7,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,55.1,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid,Administrative,40.6,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Mississippi,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,53.8,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 11,931.",Yes
Mississippi,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,55.5,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 11,926.",Yes
Mississippi,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,21.2,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,2.2,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,11.9,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,42.9,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,0.5,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,7.9,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Mississippi,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,91.9,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 15,486. Mississippi Division of Medicaid has 3 health plans, 2 of which also provide services for the CHIP population. The Medicaid and CHIP data for this report are combined and calculations for state-level rates are based on 5 units (3 plans that provide Medicaid managed care and 2 plans that provide CHIP managed care).",Yes
Mississippi,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,47.8,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Mississippi,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Hybrid,52.8,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 47,704.",Yes
Mississippi,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,60.2,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Missouri,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,59.6,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,54.9,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in the state's numerators and denominators for this measure.,Yes
Missouri,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,35.4,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in the state's numerators and denominators for this measure.,Yes
Missouri,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,8.2,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. Missouri has implemented pharmacy edits designed to drive down inappropriate benzodiazepine and opioid usage.,Yes
Missouri,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,71.2,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in our numerators and denominators for this measure. Additionally, we stopped disenrolling people during the pandemic.",Yes
Missouri,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,13.6,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in our numerators and denominators for this measure. Additionally, we stopped disenrolling people during the pandemic.",Yes
Missouri,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,20.7,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in our numerators and denominators for this measure. Additionally, we stopped disenrolling people during the pandemic.",Yes
Missouri,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,28.0,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in our numerators and denominators for this measure. Additionally, we stopped disenrolling people during the pandemic.",Yes
Missouri,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,40.1,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in our numerators and denominators for this measure. Additionally, we stopped disenrolling people during the pandemic.",Yes
Missouri,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,28.4,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in our numerators and denominators for this measure. Additionally, we stopped disenrolling people during the pandemic.",Yes
Missouri,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,43.0,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in our numerators and denominators for this measure. Additionally, we stopped disenrolling people during the pandemic.",Yes
Missouri,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,46.0,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,12.5,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,63.6,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,32.2,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,46.8,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,14.4,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,47.4,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,15.2,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,77.1,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,54.0,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,43.9,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,2.8,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,70.0,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs).,Yes
Missouri,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,63.3,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,67.5,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,63.9,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Missouri,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,85.6,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs).,Yes
Missouri,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,1.3028,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,35.1,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & CHIP,Administrative,90.1,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. These are somewhat healthier individuals than other members, and we believe this accounts for part of the rate improvement this year.",Yes
Missouri,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,65.0,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,4.7,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,93.7,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include the entire developmental disabilities (DD) population of adults 18 and older who receive at least one authorized service in addition to support coordination enrollees. Funding sources include 1915(c) waivers, state plan funding, and general revenue. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 15,434. The state provided the following information about the sampling or survey methodology: The number of surveys assigned to each strata (region) is based upon the number of QASs assigned to each regional office. Each full-time QAS is assigned 13 surveys.",Yes
Missouri,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,95.2,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include the entire developmental disabilities (DD) population of adults 18 and older who receive at least one authorized service in addition to support coordination enrollees. Funding sources include 1915(c) waivers, state plan funding, and general revenue. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 15,434. The state provided the following information about the sampling or survey methodology: The number of surveys assigned to each strata (region) is based upon the number of QASs assigned to each regional office. Each full-time QAS is assigned 13 surveys.",Yes
Missouri,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,26.2,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,5.2,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,11.6,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,40.4,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,2.3,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,11.8,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Administrative,53.8,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Missouri,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,40.4,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. The pandemic has been reported to have had a negative impact on breast cancer screenings.,Yes
Missouri,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Administrative,43.4,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs).,Yes
Missouri,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,35.4,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021. This accounts for large increases in our numerators and denominators for this measure. Additionally, we stopped disenrolling people during the pandemic.",Yes
Missouri,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & CHIP,CAHPS 5.1H,49.3,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs). Missouri added the Adult Expansion Group in July 2021.,Yes
Nebraska,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,67.5,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,63.9,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,49.0,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,21.8,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,80.7,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.9,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,23.8,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,34.6,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,51.5,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,35.1,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.5,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,NR,45,42.1,39.2,45.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,NR,45,12.2,8.1,14.4,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,NR,43,56.6,50.1,64.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,NR,43,29.5,17.5,37.4,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,NR,43,41.3,36.9,44.8,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,NR,43,11.0,7.9,15.1,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",No
Nebraska,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,42.0,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,12.4,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,67.7,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Nebraska,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,63.1,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Nebraska,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,60.0,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Nebraska,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,4.1,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,38.4,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,65.4,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,62.5,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,64.9,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,39.7,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative & Hybrid,70.6,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rate was derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is not available.",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative & Hybrid,25.6,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rate was derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is not available.",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,22.3,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,29.1,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,33.4,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,1.9,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,95.8,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include 4154 HCBS Comprehensive Waiver, 0394 HCBS Adult Day Waiver, and ICF/IID enrollees. Funding sources include 1915(c) waivers and intermediate care facilities for individuals with intellectual disabilities (ICF/IID) funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 4,848. The state provided the following information about the sampling or survey methodology: Proportionate by district and ICF.",Yes
Nebraska,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,88.6,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include 4154 HCBS Comprehensive Waiver, 0394 HCBS Adult Day Waiver, and ICF/IID enrollees. Funding sources include 1915(c) waivers and intermediate care facilities for individuals with intellectual disabilities (ICF/IID) funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 4,848. The state provided the following information about the sampling or survey methodology: Proportionate by district and ICF.",Yes
Nebraska,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,27.9,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,6.7,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (2 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,8.4,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,38.0,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,0.3,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,13.9,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative & Hybrid,58.8,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rate was derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is not available.",Yes
Nebraska,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,57.4,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative & Hybrid,48.7,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System."" Rate was derived using both administrative and hybrid method data. One plan used administrative data and 2 plans used the hybrid method. The measure-eligible population is 53,403.",Yes
Nebraska,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,40.6,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Claim System.""",Yes
Nebraska,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,53.3,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (2 MCOs).,Yes
Nevada,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,38.5,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,74.4,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,11.2,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,15.5,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,34.6,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,45.2,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,29.7,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,45.6,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,40.6,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,11.3,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,55.5,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,23.0,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,42.7,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,11.0,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,43.0,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,13.1,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,50.3,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,51.8,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,50.7,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,59.5,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs).,Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,43.2,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 21,724. Rate was audited or validated.",Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,57.8,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 28,805. Rate was audited or validated.",Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,1.2537,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,11.5,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs).,Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.3,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs).,Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,22.3,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs).,Yes
Nevada,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,3.0,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (3 MCOs).,Yes
Nevada,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,93.1,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Nevada's Home and Community-Based Waiver for Individuals with Intellectual and Developmental Disabilities enrollees. Funding source includes a 1915(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 2,708. The state provided the following information about the sampling or survey methodology: Proportionate by region. Individuals receiving only Targeted Case Management (TCM) services; residing in ICF/IIDs, skilled nursing or other institutional settings; or receiving TCM and family support services only are excluded from this sample.",Yes
Nevada,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,91.5,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Nevada's Home and Community-Based Waiver for Individuals with Intellectual and Developmental Disabilities enrollees. Funding source includes a 1915(c) waiver. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 2,708. The state provided the following information about the sampling or survey methodology: Proportionate by region. Individuals receiving only Targeted Case Management (TCM) services; residing in ICF/IIDs, skilled nursing or other institutional settings; or receiving TCM and family support services only are excluded from this sample.",Yes
Nevada,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,16.2,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,2.8,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,8.7,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,24.3,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,0.2,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,4.7,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (3 MCOs).,Yes
Nevada,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,71.6,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Denominator is the sample size; measure-eligible population is 11,533. Rate was audited or validated.",Yes
Nevada,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,46.2,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,72.2,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rate was audited or validated. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,65.1,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,50.0,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,23.2,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,77.0,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rate was audited or validated. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,30.5,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,43.5,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,65.9,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,74.2,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,62.9,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). Medicare and Medicaid dually-eligible population is included. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE). Includes paid and denied claims/encounters. Members were assigned to a plan based on their latest enrollment date within the calendar year. There was no consideration for members who may have died during the measurement period.",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,76.0,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). Medicare and Medicaid dually-eligible population is included. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE). Includes paid and denied claims/encounters. Members were assigned to a plan based on their latest enrollment date within the calendar year. There was no consideration for members who may have died during the measurement period.",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,52.1,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,21.7,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,69.3,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,42.2,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,46.2,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,18.2,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,53.8,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,25.4,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,75.6,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Medicare and Medicaid dually-eligible population is excluded. Rates were audited or validated. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).,Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,57.1,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Medicare and Medicaid dually-eligible population is excluded. Rates were audited or validated. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).,Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,51.6,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Medicare and Medicaid dually-eligible population is excluded. Rates were audited or validated. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).,Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid,Administrative,8.7,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,79.7,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" State reported the following deviations: ""Numerator - Added H0033, J1230, Q9991 and Q9992 to the ""OUD-B"" value set. Denominator - Added the F11.9, F11.9xx to the ""OUD-A"" value set. Utilized all medical claims with an opioid diagnosis. Did not exclude professional claims."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,51.2,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,53.7,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,51.8,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid,Administrative,44.6,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rate was audited or validated. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,43.5,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 5,893. Rate was audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,57.0,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 7,208. Rate was audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,1.1658,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rates were audited or validated. Submitted values are based on HEDIS data for reporting year 2021, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,14.2,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid,Administrative,23.9,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,16.1,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,DS,33,3.1,4.7,2.2,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",No
New Hampshire,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,25.8,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,5.9,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,12.3,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,41.7,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,1.7,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,14.2,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,79.0,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 2,838. Rate was audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,50.9,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rate was audited or validated. Submitted values are based on HEDIS data for reporting year 2022, yet the age groups were split up according to the CMS specified age group for that measure where it was applicable. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Hybrid,57.3,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Denominator is the sample size; measure-eligible population is 40,588. Rate was audited or validated. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,54.9,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). FFS enrollees and Medicare and Medicaid dually-eligible population are excluded. The state described the ""other"" data sources used to calculate the measure as the following: ""The managed care organizations' data are from their claims system."" Rate was audited or validated. Medicaid enrollment continues to increase due to the population's Medicaid eligibility being protected under the ongoing public health emergency (PHE).",Yes
New Hampshire,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,45.4,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Medicare and Medicaid dually-eligible population is excluded. This measure data is based on CAHPS survey results, the rates are weighted.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,67.1,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,61.4,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,46.5,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,81.8,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,15.6,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,22.7,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.2,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,61.9,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,26.5,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,43.6,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,42.1,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,6.1,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.5,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,22.8,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,43.1,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,5.4,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,44.4,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,10.8,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,73.1,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,47.0,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,40.5,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). Rates were audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,63.1,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,62.6,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,62.9,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,42.8,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,34.2,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 85,108. Rate was audited or validated. The State of New Jersey reported a combined rate for all measure-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,59.3,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 134,084. Rate was audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""18-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,1.1366,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,15.0,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""AHRQ measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,86.0,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Supports Program and Community Care Program enrollees. Funding source includes an 1115 demonstration. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 24,330. The state provided the following information about the sampling or survey methodology: Proportionate by program/waiver type and geographical region. Individuals living in Developmental Centers are excluded from this sample.",Yes
New Jersey,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,93.2,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Supports Program and Community Care Program enrollees. Funding source includes an 1115 demonstration. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 24,330. The state provided the following information about the sampling or survey methodology: Proportionate by program/waiver type and geographical region. Individuals living in Developmental Centers are excluded from this sample.",Yes
New Jersey,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,24.0,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,2.6,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,8.2,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,33.3,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,0.1,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,4.8,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HHS Office of Population Affairs (OPA) 2021 administrative collection method submitted by the MCOs."" Rates were audited or validated.",Yes
New Jersey,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,80.4,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 24,073. Rate was audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,55.1,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated. The State of New Jersey reported a combined rate for all member-eligible enrollees in the ages ""50-64"" performance measure section. NJ does not stratify this measure by age.",Yes
New Jersey,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,58.4,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 hybrid collection method submitted by the MCOs."" Denominator is the sample size; measure-eligible population is 369,344. Rate was audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,65.2,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HEDIS measurement year 2021 administrative collection method submitted by the MCOs."" Rate was audited or validated.",Yes
New Jersey,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,36.1,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (5 MCOs). Rate was audited or validated.,Yes
New Mexico,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,54.0,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rate was audited or validated.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,61.8,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,43.1,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,78.1,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rate was audited or validated.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,15.1,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,22.5,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,40.6,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. Data source for this measure is HEDIS, which requires each product line to be reported separately. HEDIS Medicaid product line is what is reported for this measure.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,53.8,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. Data source for this measure is HEDIS, which requires each product line to be reported separately. HEDIS Medicaid product line is what is reported for this measure.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,31.5,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. Data source for this measure is HEDIS, which requires each product line to be reported separately. HEDIS Medicaid product line is what is reported for this measure.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,49.4,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. Data source for this measure is HEDIS, which requires each product line to be reported separately. HEDIS Medicaid product line is what is reported for this measure.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,46.2,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,17.2,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,61.8,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,24.1,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,31.4,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,16.4,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,48.9,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,18.1,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,64.6,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.,Yes
New Mexico,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,40.9,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.,Yes
New Mexico,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,35.6,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.,Yes
New Mexico,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,63.9,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,68.5,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,65.3,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid,Administrative,43.0,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO audited HEDIS."" Rate was audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data.",Yes
New Mexico,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,52.6,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 41,433. Rate was audited or validated. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,49.6,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 44,645. Rate was audited or validated. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65-85.",Yes
New Mexico,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,0.6870,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rates were audited or validated.",Yes
New Mexico,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,17.5,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Reports submitted by MCOs directly on state-prescribed templates."" Technical Specifications provided to the MCOs for this measure did not include Medicare and Medicaid Dully-Eligible population. Only the Medicaid population was reported for this measure.",Yes
New Mexico,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,65.7,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Denominator is the sample size; measure-eligible population is 11,529. Rate was audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,36.1,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rate was audited or validated. The data reported is an aggregate total of all 3 MCOs administrative data. Calendar year 2021 HEDIS does not provide these measures by the requested age group of 65+.",Yes
New Mexico,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative & Hybrid,44.0,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rate was derived using both administrative and hybrid method data. One MCO reported this measure as administrative and two reported as hybrid. The measure-eligible population is 181,450. Rate was audited or validated. The reported data for calendar year 2021 HEDIS has been verified.",Yes
New Mexico,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,54.9,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Audited HEDIS."" Rate was audited or validated.",Yes
New Mexico,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,40.2,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
New York,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,64.9,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (54 MCOs). Rate was audited or validated.,Yes
New York,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,56.9,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (54 MCOs). Rates were audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.,Yes
New York,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,41.8,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (54 MCOs). Rates were audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.,Yes
New York,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,16.4,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (55 MCOs). Rate was audited or validated. Numerator and denominator include age 65+ population.,Yes
New York,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,75.7,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (53 MCOs). Rate was audited or validated.,Yes
New York,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,21.3,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (46 MCOs). Rates were audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.,Yes
New York,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,27.4,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (46 MCOs). Rates were audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.,Yes
New York,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,61.0,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (44 MCOs). Rates were audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.,Yes
New York,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,70.7,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (44 MCOs). Rates were audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.,Yes
New York,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,51.4,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (46 MCOs). Rates were audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.,Yes
New York,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,66.6,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (46 MCOs). Rates were audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.,Yes
New York,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,47.2,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (28 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,15.9,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (28 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,65.4,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (28 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,35.5,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (28 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,50.2,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (28 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,16.6,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (28 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,49.1,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (28 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,18.9,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (28 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plan Billing Data."" Rates were audited or validated.",Yes
New York,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,82.4,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (28 MCOs). Rates were audited or validated. Our data include age 65+ and exclude duals.,Yes
New York,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,67.4,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (28 MCOs). Rates were audited or validated. Our data include age 65+ and exclude duals.,Yes
New York,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,59.6,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (28 MCOs). Rates were audited or validated. Our data include age 65+ and exclude duals.,Yes
New York,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,65.2,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (61 MCOs). Rate was audited or validated.,Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,49.2,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (51 MCOs). Rates were audited or validated.,Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,50.3,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (51 MCOs). Rates were audited or validated.,Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,49.6,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (51 MCOs). Rates were audited or validated.,Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid,Administrative,45.3,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (26 MCOs). Rate was audited or validated. State reported using HEDIS age groups.,Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,35.8,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (28 MCOs). Sample size is 11,435; measure-eligible population is 289,703. Rate was audited or validated. Our data include age 65+ and exclude duals.",Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,64.0,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (28 MCOs). Sample size is 11,190; measure-eligible population is 433,437. Rate was audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.",Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,0.9598,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (28 MCOs). Rates were audited or validated.,Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,11.4,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (61 MCOs). Rate was audited or validated. Our data include age 65+ and exclude duals.,Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid,Administrative,27.8,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (61 MCOs). Rate was audited or validated. Our data include age 65+ and exclude duals.,Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,17.1,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (61 MCOs). Rate was audited or validated. Our data include age 65+ and exclude duals.,Yes
New York,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,4.9,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (49 MCOs). Rate was audited or validated.,Yes
New York,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,86.3,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include individuals enrolled in one service in addition to Care Management; Partners Health Plan (PHP), Fully Integrated Duals Advantage - Intellectual and/or Developmental Disabilities (FIDA-IDD) enrollees. Funding sources include a 1915(c) waiver, state funding, a Federal Alignment Initiative demonstration, and other sources. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 66,600. The state provided the following information about the sampling or survey methodology: Proportionate by Care Coordination Organization (CCO). Individuals dually enrolled in Medicaid/Medicare who opted into the Fully Integrated Duals Advantage (FIDA) managed care program are excluded from this sample.",Yes
New York,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,91.8,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include individuals enrolled in one service in addition to Care Management; Partners Health Plan (PHP), Fully Integrated Duals Advantage - Intellectual and/or Developmental Disabilities (FIDA-IDD) enrollees. Funding sources include a 1915(c) waiver, state funding, a Federal Alignment Initiative demonstration, and other sources. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 66,600. The state provided the following information about the sampling or survey methodology: Proportionate by Care Coordination Organization (CCO). Individuals dually enrolled in Medicaid/Medicare who opted into the Fully Integrated Duals Advantage (FIDA) managed care program are excluded from this sample.",Yes
New York,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,23.6,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (64 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,3.5,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (64 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,12.5,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (41 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,37.5,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (41 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,4.4,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (41 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,10.5,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (41 MCOs). Rates were audited or validated.,Yes
New York,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,76.5,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (28 MCOs). Denominator is the sample size; measure-eligible population is 89,003. Rate was audited or validated.",Yes
New York,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,57.6,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (59 MCOs). Rate was audited or validated. State reported using HEDIS age groups. Numerator and denominator include age 65+ population.,Yes
New York,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative,54.5,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (60 MCOs). Rate was audited or validated.,Yes
New York,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,68.5,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (39 MCOs). Rate was audited or validated.,Yes
New York,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,49.4,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (28 MCOs). Rate was audited or validated.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,64.0,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. NC Medicaid only includes ages 18 - 64 in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,54.1,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,33.9,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,13.1,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,77.1,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,15.5,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,23.2,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,38.8,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,52.9,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,20.3,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,35.4,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,45.1,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,12.5,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,55.2,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,29.7,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,41.8,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,10.2,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,44.4,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,16.0,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid,Administrative,7.7,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. NC Medicaid only includes ages 18 - 64 in this measure.,Yes
North Carolina,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,56.1,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,60.9,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,56.7,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,60.1,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid,Administrative,52.9,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Administrative,24.6,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Information Exchange (HIE) data were included for this measure."" All adults ages 18 - 64 were captured in this measure.",Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,0.9323,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,19.6,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid,Administrative,39.8,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,32.7,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,2.6,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,85.1,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include ICF/IID (Community Based), Developmental Centers, Innovations Waiver, (b)(3) Services, and Medicaid State Plan enrollees. Funding sources include ICF/IID funding, a 1915(c) waiver, 1915(b) waiver, and state plan funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 22,114. The state provided the following information about the sampling or survey methodology: Approximately proportional random sampling by LME-MCO and Developmental Centers of adults 18 and over who received at least one Medicaid I/DD service in previous fiscal year. Individuals receiving state-funded IDD services are excluded from this sample.",Yes
North Carolina,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,96.7,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include ICF/IID (Community Based), Developmental Centers, Innovations Waiver, (b)(3) Services, and Medicaid State Plan enrollees. Funding sources include ICF/IID funding, a 1915(c) waiver, 1915(b) waiver, and state plan funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 22,114. The state provided the following information about the sampling or survey methodology: Approximately proportional random sampling by LME-MCO and Developmental Centers of adults 18 and over who received at least one Medicaid I/DD service in previous fiscal year. Individuals receiving state-funded IDD services are excluded from this sample.",Yes
North Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,21.6,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,3.9,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,14.8,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,40.1,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,3.2,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,12.3,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (5 MCOs). Rates were audited or validated.,Yes
North Carolina,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Administrative,53.7,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,31.5,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated. All adults ages 18 - 64 were captured in this measure.,Yes
North Carolina,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative,40.7,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Carolina,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,62.2,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (5 MCOs). Rate was audited or validated.,Yes
North Dakota,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,57.8,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,59.3,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,40.4,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,13.3,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
North Dakota,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,78.5,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO). The state described the ""other"" data sources used to calculate the measure as the following: ""EHR data.""",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,24.4,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,33.9,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & Dual Eligibles,Administrative,44.6,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,62.7,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,29.1,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,53.2,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,42.5,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,14.4,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,64.6,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,44.2,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,41.5,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,16.9,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,43.9,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,18.9,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,DS,32,6.7,9.0,3.2,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO).",No
North Dakota,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,51.6,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,86.0,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,88.9,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,86.6,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,54.4,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,35.8,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (1 MCO). Denominator is the sample size; measure-eligible population is 2,115.",Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,67.8,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (1 MCO). Denominator is the sample size; measure-eligible population is 2,685.",Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,0.8511,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (1 MCO).,Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,25.5,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & Dual Eligibles,Administrative,35.1,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,30.1,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,3.8,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,24.6,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,5.8,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,Yes
North Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,7.8,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
North Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,38.6,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
North Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,DS,37,2.1,0.9,3.0,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,No
North Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,10.8,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
North Dakota,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Administrative,43.8,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
North Dakota,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,36.3,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO).",Yes
North Dakota,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative & Hybrid,41.3,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO). Rate was derived using both administrative and hybrid method data. Administrative method was used for FFS and PCCM populations; the hybrid method was used for managed care populations. The measure-eligible population is 8,981.",Yes
North Dakota,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative & Electronic Health Records,41.3,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM, and managed care populations (1 MCO).",Yes
Ohio,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,56.3,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rate was audited or validated.",Yes
Ohio,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,56.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,37.4,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,77.2,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rate was audited or validated.",Yes
Ohio,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,18.3,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,28.7,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,37.0,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. The reported data is for the Medicaid-only Managed Care population.",Yes
Ohio,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,51.5,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. The reported data is for the Medicaid-only Managed Care population.",Yes
Ohio,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,41.1,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. The reported data is for the Medicaid-only Managed Care population.",Yes
Ohio,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,63.2,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. The reported data is for the Medicaid-only Managed Care population.",Yes
Ohio,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,46.9,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,16.4,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,69.0,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,45.3,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,50.1,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,19.3,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,52.1,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,23.0,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 and older).""",Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,54.8,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,53.4,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,54.5,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,35.6,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rate was audited or validated. The reported data is for the Medicaid-only Managed Care population.",Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,44.5,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 121,510. Rate was audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18 to 75).""",Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,57.4,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 190,722. Rate was audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 18-85).""",Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,0.9936,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rates were audited or validated.",Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,15.4,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (6 MCOs).,Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,36.3,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (6 MCOs).,Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,26.6,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (6 MCOs).,Yes
Ohio,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,3.3,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (6 MCOs).,Yes
Ohio,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,89.3,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include 1915(c) waivers, ICF/IIDs, and county board funded supports enrollees. Funding sources include 1915(c) waivers, ICF/IID funding, and county board funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 51,563. The state provided the following information about the sampling or survey methodology: Simple random sample.",Yes
Ohio,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,94.5,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include 1915(c) waivers, ICF/IIDs, and county board funded supports enrollees. Funding sources include 1915(c) waivers, ICF/IID funding, and county board funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 51,563. The state provided the following information about the sampling or survey methodology: Simple random sample.",Yes
Ohio,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,25.4,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,4.2,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.9,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,40.7,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,4.9,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,11.7,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (6 MCOs).,Yes
Ohio,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,77.4,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 48,681. Rate was audited or validated.",Yes
Ohio,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,49.6,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rate was audited or validated. State reported the following deviations: ""The numerator, denominator and rate for this measure is reported for the Statewide Ohio Medicaid Managed Care Program. The numerator is the sum of the 5 Ohio Medicaid managed care plans' HEDIS measurement year 2021 reported numerators (for Ages 50-74).""",Yes
Ohio,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Hybrid,58.3,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the hybrid method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Denominator is the sample size; measure-eligible population is 623,962.",Yes
Ohio,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,64.6,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Managed care claim rates were calculated on a per-plan basis using the administrative method with data coming from an appropriate source as determined by NCQA-certified Managed Care Plans."" Rate was audited or validated.",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & Dual Eligibles,Administrative,68.9,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,50.6,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,30.8,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,9.1,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,71.6,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,7.0,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,10.9,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & Dual Eligibles,Administrative,39.8,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,51.9,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,24.9,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,42.3,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,27.7,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,2.6,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,29.9,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,11.5,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,27.2,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,3.2,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,27.4,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,4.9,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,#,27,72.6,64.6,74.4,# = Rate not reported because fewer than 100 beneficiaries responded to the survey question,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,No
Oklahoma,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,#,27,49.9,46.1,57.7,# = Rate not reported because fewer than 100 beneficiaries responded to the survey question,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,No
Oklahoma,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,#,27,44.2,40.5,49.3,# = Rate not reported because fewer than 100 beneficiaries responded to the survey question,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and PCCM populations.,No
Oklahoma,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,3.4,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,33.9,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & Dual Eligibles,Administrative,85.6,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & Dual Eligibles,Administrative,89.2,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & Dual Eligibles,Administrative,86.8,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,44.3,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,1.0169,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,24.4,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes PCCM and FFS populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & Dual Eligibles,Administrative,44.5,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,48.8,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & Dual Eligibles,Administrative,4.7,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,83.4,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include In-Home Supports Waiver - Adult, the Community Waiver - Non-Residential, the Community Waiver - Residential, and Homeward Bound Waiver enrollees. Funding source includes 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 5,144. The state provided the following information about the sampling or survey methodology: Proportionate by HCBS waiver groups.",Yes
Oklahoma,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,99.4,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include In-Home Supports Waiver - Adult, the Community Waiver - Non-Residential, the Community Waiver - Residential, and Homeward Bound Waiver enrollees. Funding source includes 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 5,144. The state provided the following information about the sampling or survey methodology: Proportionate by HCBS waiver groups.",Yes
Oklahoma,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,22.6,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,4.0,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,11.7,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,39.9,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,1.3,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,9.1,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and PCCM populations. State reported that rates exclude the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & Dual Eligibles,Administrative,30.6,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days."" Oklahoma bills prenatal and postpartum care using a global code. If global codes were included in the rate, it would be: Denominator: 22,262 Numerator: 11,525; Rate: 51.8%.",Yes
Oklahoma,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,31.3,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & Dual Eligibles,Administrative,37.5,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & Dual Eligibles,Administrative,43.4,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oklahoma,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & Dual Eligibles,CAHPS 5.1H,39.9,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and PCCM populations. State reported that the rate excludes the following populations: ""Excluded members enrolled in a Home or Community Based Waiver."" State reported the following deviation: ""Calculation allows any number of allowable gaps up to 45 days instead of just one gap of up to 45 days.""",Yes
Oregon,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,52.8,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs).,Yes
Oregon,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,65.8,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs).,Yes
Oregon,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,38.0,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Rates were audited or validated.,Yes
Oregon,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.4,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Rates were audited or validated.,Yes
Oregon,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,57.7,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Rates were audited or validated.,Yes
Oregon,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,29.2,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Rates were audited or validated.,Yes
Oregon,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,37.3,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Rates were audited or validated.,Yes
Oregon,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,13.6,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Rates were audited or validated.,Yes
Oregon,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,39.2,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Rates were audited or validated.,Yes
Oregon,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.1,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs). Rates were audited or validated.,Yes
Oregon,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,62.9,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (16 CCOs).,Yes
Oregon,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,46.1,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (16 CCOs).,Yes
Oregon,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,40.3,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (16 CCOs).,Yes
Oregon,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Electronic Health Records,27.0,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (16 CCOs). State reported the following deviations: ""Oregon obtains EHR-based aggregated results from health plans based on 'ages 18-75,' and state is unable to stratify by age groups. Results reported in the 'ages 18-64' category represents all members ages 18-75.""",Yes
Oregon,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Electronic Health Records,67.8,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (16 CCOs). State reported the following deviations: ""Oregon obtains EHR-based aggregated results from health plans based on 'ages 18-85,' and state is unable to stratify by age groups. Results reported in the 'ages 18-64 group' represent all members ages 18-85.""",Yes
Oregon,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,0.7490,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (16 CCOs).,Yes
Oregon,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.7,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,15.6,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,23.3,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,2.1,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,91.2,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include In Home-Direct Services Only, In-Home-Day Supports Only, In Home-Employment Services and Day Support, In Home- Employment Services Only, 24-Hour Residential Services for Adults, Adult Foster Care, Supported Living Services for Adults, and Stabilization and Crisis Unit enrollees. Funding sources include a combination of 1915(b)/(c) waivers and Community First Choice 1915(k) state plan option. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 18,483. The state provided the following information about the sampling or survey methodology: Stratified by setting, county, and race/ethnicity.",Yes
Oregon,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,88.1,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include In Home-Direct Services Only, In-Home-Day Supports Only, In Home-Employment Services and Day Support, In Home- Employment Services Only, 24-Hour Residential Services for Adults, Adult Foster Care, Supported Living Services for Adults, and Stabilization and Crisis Unit enrollees. Funding sources include a combination of 1915(b)/(c) waivers and Community First Choice 1915(k) state plan option. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 18,483. The state provided the following information about the sampling or survey methodology: Stratified by setting, county, and race/ethnicity.",Yes
Oregon,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,77.8,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (16 CCOs). Denominator is the sample size; measure-eligible population is 12,915.",Yes
Oregon,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,49.4,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,54.4,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (16 CCOs).,Yes
Oregon,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,35.3,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (16 CCOs).,Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,66.3,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. State reported the following deviations: ""physical health (PH) MCOs collect and report this measure through HEDIS. However, due to the separation of PH and behavioral health (BH) services for Medicaid, a methodology was developed to capture BH claims by enhancing the PH data with BH data from the PROMISe encounter data system, in order to have a more accurate reporting of individuals with schizophrenia and their adherence. The rates from the Medicaid PH MCOs and the rates including the BH data are included.""",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,61.2,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The numerator, denominator, and rate are calculated as a single rate per HEDIS specification of ages 18 and older. Data are not available for individual age brackets.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,43.8,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. The numerator, denominator, and rate are calculated as a single rate per HEDIS specification of ages 18 and older. Data are not available for individual age brackets.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,16.5,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,86.9,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,19.1,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,29.0,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,40.4,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,53.3,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,34.3,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,53.7,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (5 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,32.7,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,9.0,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,38.3,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,19.4,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,35.7,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,10.0,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,34.0,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,11.4,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated. There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,52.4,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (8 MCOs). We use a combined rate for all ages. This measure is collected through CAHPS Health Plan Survey. CAHPS and survey questions have previously been pulled by DHS from another source. EQRO does not collect these data - they are part of the CAHPS information sent directly to DHS by the MCOs.,Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,30.4,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (8 MCOs). We use a combined rate for all ages. This measure is collected through CAHPS Health Plan Survey. CAHPS and survey questions have previously been pulled by DHS from another source. EQRO does not collect these data - they are part of the CAHPS information sent directly to DHS by the MCOs.,Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,27.3,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (8 MCOs). We use a combined rate for all ages. This measure is collected through CAHPS Health Plan Survey. CAHPS and survey questions have previously been pulled by DHS from another source. EQRO does not collect these data - they are part of the CAHPS information sent directly to DHS by the MCOs.,Yes
Pennsylvania,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid,Administrative,76.2,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,59.2,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,60.0,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,59.4,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid,Administrative,49.5,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (8 MCOs). Rate was audited or validated.,Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,36.1,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rate was audited or validated. The numerator, denominator, and rate entered for ages 18-64 also includes ages 65-74.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,65.2,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rate was audited or validated. The numerator, denominator and rate are calculated as a single rate per HEDIS specification of ages 18 and older, including ages 65-85.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,0.9478,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,18.2,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. State reported the following deviation: ""Age was determined at age of discharge."" There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid,Administrative,34.8,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. State reported the following deviation: ""Age was determined at age of discharge."" There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,21.0,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. State reported the following deviation: ""Age was determined at age of discharge."" There are no Medicare or dual-eligibles included in the Pennsylvania HealthChoices managed care program.",Yes
Pennsylvania,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,5.5,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. State reported the following deviation: ""Age was determined at age of discharge.""",Yes
Pennsylvania,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,95.5,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Consolidated Waiver, Person/Family-Directed Supports (P/FDS), Community Living Waiver, Base Funding, and ICF/IID enrollees. Funding sources include 1915(c) waivers, base funding, and ICF/IID funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 38,346. The state provided the following information about the sampling or survey methodology: Stratified by administrative entity.",Yes
Pennsylvania,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,97.1,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Consolidated Waiver, Person/Family-Directed Supports (P/FDS), Community Living Waiver, Base Funding, and ICF/IID enrollees. Funding sources include 1915(c) waivers, base funding, and ICF/IID funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 38,346. The state provided the following information about the sampling or survey methodology: Stratified by administrative entity.",Yes
Pennsylvania,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,26.6,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,4.2,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,18.0,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,42.3,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,5.6,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,12.0,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rates were audited or validated.",Yes
Pennsylvania,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,79.6,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rate was audited or validated.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,50.9,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated. The numerator, denominator and rate entered are for ages 52-74.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Hybrid,60.5,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO. Each MCO calculated its hybrid rates following strict HEDIS specifications."" Denominator is the sample size, which is equivalent to the measure-eligible population. Rate was audited or validated.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,61.4,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (8 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Data submitted by managed care plans and compiled by the EQRO."" Rate was audited or validated.",Yes
Pennsylvania,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,40.8,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (8 MCOs). This measure is collected through CAHPS Health Plan Survey. CAHPS and survey questions have previously been pulled by DHS from another source. EQRO does not collect these data - they are part of the CAHPS information sent directly to DHS by the MCOs.,Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,66.2,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,54.7,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,42.1,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,16.1,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,61.4,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,10.9,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,24.1,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,19.2,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,60.7,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,22.3,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,59.2,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,56.6,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,11.8,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,NR,43,56.6,50.1,64.6,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",No
Puerto Rico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,NR,43,29.5,17.5,37.4,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",No
Puerto Rico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,NR,43,41.3,36.9,44.8,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",No
Puerto Rico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,NR,43,11.0,7.9,15.1,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",No
Puerto Rico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,NR,44,43.4,41.0,47.7,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",No
Puerto Rico,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,NR,44,15.8,10.5,18.5,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",No
Puerto Rico,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,64.6,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (1 MCO). Rates were audited or validated.,Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,16.6,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (1 MCO). Rates were audited or validated.,Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,16.6,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (1 MCO). Rates were audited or validated.,Yes
Puerto Rico,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,DS,32,6.7,9.0,3.2,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",No
Puerto Rico,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,64.8,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,NR,45,57.8,53.8,63.1,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",No
Puerto Rico,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,NR,45,58.0,53.4,62.9,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",No
Puerto Rico,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,72.3,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,73.4,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Sample size and measure-eligible population are not available. Rate was audited or validated.",Yes
Puerto Rico,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,39.6,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Sample size and measure-eligible population are not available. Rate was audited or validated.",Yes
Puerto Rico,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,21.9,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,116.3,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,71.8,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,27.1,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,3.7,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,0.3,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,27.1,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,33.0,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,DS,37,2.1,0.9,3.0,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",No
Puerto Rico,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,0.6,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rates were audited or validated.",Yes
Puerto Rico,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,38.0,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Sample size and measure-eligible population are not available. Rate was audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,56.3,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Administrative,42.2,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,60.3,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO claims."" Rate was audited or validated.",Yes
Puerto Rico,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & CHIP,CAHPS 5.1H,22.2,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (1 MCO). Rate was audited or validated.,Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,75.0,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care plans in HEDIS reports."" Rate was audited or validated.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,64.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data from HEDIS reports submitted to the state by health plans."" Rates were audited or validated. Ages 18-64 rates include individuals age 65 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,47.8,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data from HEDIS reports submitted to the state by health plans."" Rates were audited or validated. Ages 18-64 rates include individuals age 65 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,74.9,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care plans in HEDIS reports."" Rate was audited or validated.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,14.9,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,25.8,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,59.9,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,72.4,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,51.8,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,73.4,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,40.6,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,15.1,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,60.9,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,35.3,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,36.9,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,10.5,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,40.8,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,16.4,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,58.6,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care plans in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,58.6,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care plans in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,58.6,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care plans in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,40.1,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Health plans (MCO) administrative data as reported in HEDIS reports."" Rate was audited or validated.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,33.6,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rate was audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,70.4,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rate was audited or validated. The Ages 18 to 64 rates include all individuals age 18 and older.",Yes
Rhode Island,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,1.1065,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). State reported that rates exclude the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Rates were audited or validated.",Yes
Rhode Island,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,85.6,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,61.0,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as reported by health plans in HEDIS reports."" Rate was audited or validated. The Ages 50 to 64 rate includes individuals ages 50 to 74.",Yes
Rhode Island,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Hybrid,68.0,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Administrative data as provided by Medicaid Managed Care Organizations in HEDIS reports."" Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,63.9,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" The state described the ""other"" data sources used to calculate the measure as the following: ""Health plan claims systems used to generate HEDIS reports."" Rate was audited or validated.",Yes
Rhode Island,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & CHIP,CAHPS 5.1H,47.8,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). State reported that the rate excludes the following populations: ""Excluding Medicaid population not covered under managed care."" Rates were calculated based on CAHPS Survey reports. A weighted average was calculated based on numerators and denominators in each of three MCO CAHPS reports submitted to the State of RI.",Yes
South Carolina,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,61.7,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,48.8,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,32.2,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,13.0,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,77.8,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,11.6,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,16.1,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,32.9,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,47.4,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,23.3,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,37.0,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,40.0,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,7.1,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,60.5,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,36.6,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,38.2,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,7.9,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,42.0,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,12.3,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,74.2,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,53.3,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,49.0,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,2.7,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,56.2,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,57.4,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,54.0,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,56.8,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,34.5,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,54.2,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 37,008. The Ages 18 to 64 rate includes data for individuals ages 18 to 85. The denominator includes the CHIP population ages 18 to 21. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,0.9731,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,16.9,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & CHIP,Administrative,36.5,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,19.1,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,1.6,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,95.1,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Day and Employment Services, In-home Supports, Residential Service enrollees. Funding sources include 1915(c) waivers and state funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 19,965. The state provided the following information about the sampling or survey methodology: Stratified by provider agency and service type, based on agencies chosen for Quality Improvement Organization (QIO) review. Community-based ICF/IID Programs are excluded from this sample.",Yes
South Carolina,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,97.4,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Day and Employment Services, In-home Supports, Residential Service enrollees. Funding sources include 1915(c) waivers and state funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 19,965. The state provided the following information about the sampling or survey methodology: Stratified by provider agency and service type, based on agencies chosen for Quality Improvement Organization (QIO) review. Community-based ICF/IID Programs are excluded from this sample.",Yes
South Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,28.9,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). The denominator includes the CHIP population. Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients.,Yes
South Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,4.3,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). The denominator includes the CHIP population. Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients.,Yes
South Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,16.6,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). The denominator includes the CHIP population. Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients.,Yes
South Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,41.1,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). The denominator includes the CHIP population. Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients.,Yes
South Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,4.9,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). The denominator includes the CHIP population. Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients.,Yes
South Carolina,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,11.2,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (4 MCOs). The denominator includes the CHIP population. Population restricted to full Medicaid beneficiaries enrolled in MCO plan. FFS population only includes Family Planning Waiver Recipients.,Yes
South Carolina,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,75.4,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 20,512. The denominator includes the CHIP population ages 18 to 21. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,53.6,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Hybrid,60.5,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). Denominator is the sample size; measure-eligible population is 137,589. The denominator includes the CHIP population. Instead of using administrative rates, plan-submitted hybrid rates have been combined into an overall state rate using the weighted methodology. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.",Yes
South Carolina,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,63.8,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Carolina,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid & CHIP,CAHPS 5.1H,35.5,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). The denominator includes the CHIP population ages 18 to 21. Population restricted to full Medicaid beneficiaries enrolled in MCO plan.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,63.4,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,49.9,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,33.8,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,14.7,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,82.6,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,17.7,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,22.6,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,56.1,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,65.5,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,28.6,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,48.6,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. State reported that rates exclude the following populations: ""Any recipient with dates of service during the measure year at a Psychiatric Residential Treatment Facility (PRTF) was excluded from both the denominator and numerator because they would not have had separate codes billed for the follow-up."" State reported the following deviations: ""Since community mental health center (CMHC) visits count towards the numerator, we added a code, H2021, to the value sets. South Dakota Medicaid uses H2021 as a billable service for CMHCs funded through the Department of Social Services.""",Yes
South Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,35.5,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,7.5,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,44.4,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,17.5,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,36.7,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,9.5,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,36.2,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,9.0,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,64.0,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Our survey did not separate by age group, but dual-eligibles were not excluded.",Yes
South Dakota,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,38.8,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Our survey did not separate by age group, but dual-eligibles were not excluded.",Yes
South Dakota,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,37.3,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS population. Our survey did not separate by age group, but dual-eligibles were not excluded.",Yes
South Dakota,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,4.9,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,42.6,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,47.0,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,39.3,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,45.4,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,52.8,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,19.6,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & CHIP,Administrative,20.3,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,21.9,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,4.6,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,24.0,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,5.9,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,12.4,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,38.6,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,4.2,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,14.6,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
South Dakota,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Administrative,30.7,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,24.9,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
South Dakota,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,41.5,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,60.9,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,58.5,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with HEDIS MY 2022 specifications (ages 18+) and does not end at age 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,40.3,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with HEDIS MY 2022 specifications (ages 18+) and does not end at age 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,11.8,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,81.7,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,6.1,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS specifications (ages 18+) and do not end at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,9.9,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS specifications (ages 18+) and do not end at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,33.7,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,47.5,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,36.7,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,56.5,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,45.5,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS calculations (ages 18+) and does not stop at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,12.2,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS calculations (ages 18+) and does not stop at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,59.0,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS calculations (ages 18+) and does not stop at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,29.5,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS calculations (ages 18+) and does not stop at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,46.7,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS calculations (ages 18+) and does not stop at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,13.8,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS calculations (ages 18+) and does not stop at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,48.1,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS calculations (ages 18+) and does not stop at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,16.9,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). Rates were audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS calculations (ages 18+) and does not stop at 64.""",Yes
Tennessee,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,75.1,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,46.1,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,41.9,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,6.6,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Tennessee,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,54.2,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs).,Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,54.6,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,52.6,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,54.3,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,35.3,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,38.8,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Denominator is the measure-eligible population. Rate was audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS specifications (ages 18-75) and does not end at 64.""",Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,64.4,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Denominator is the measure-eligible population. Rate was audited or validated. State reported the following deviation: ""Age range is in accordance with HEDIS specifications (ages 18-85) and does not end at age 64.""",Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,1.0081,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,18.7,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & CHIP,Administrative,37.4,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,28.1,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Tennessee,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,2.6,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,21.8,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,4.4,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,11.8,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,39.9,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,2.5,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,12.5,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs).,Yes
Tennessee,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,73.6,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Denominator is the measure-eligible population. Rate was audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,48.9,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). Rate was audited or validated. State reported the following deviation: ""Age range is in accordance with NCQA HEDIS specifications (ages 50-74) and does not end at age 64.""",Yes
Tennessee,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Hybrid,58.3,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (4 MCOs). Denominator is the measure-eligible population. Rate was audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,56.3,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Tennessee,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,35.3,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Texas,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid,Administrative,55.8,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,54.5,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,36.3,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid,Administrative,15.9,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid,Administrative,78.7,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,3.5,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,5.8,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid,Administrative,25.4,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid,Administrative,40.0,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,31.0,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid,Administrative,51.4,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,39.7,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,7.6,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,42.9,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,13.8,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,41.3,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,9.8,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid,Administrative,40.4,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid,Administrative,9.6,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,61.0,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (17 MCOs). Rates were audited or validated.,Yes
Texas,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,38.8,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (17 MCOs). Rates were audited or validated.,Yes
Texas,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,30.5,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS and managed care populations (17 MCOs). Rates were audited or validated.,Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,63.2,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,55.3,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,61.1,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid,Administrative,43.6,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,52.1,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,53.3,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,1.1244,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,21.8,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid,Administrative,65.9,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid,Administrative,56.0,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid,Administrative,2.2,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,28.4,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid,Administrative,9.1,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,11.2,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,38.7,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,0.8,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid,Administrative,11.7,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rates were audited or validated.",Yes
Texas,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Administrative & Hybrid,75.5,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was derived using both administrative and hybrid method data. Hybrid data was used for State of Texas Access Reform (STAR) (16 MCOs). Other managed care programs (a combined total of 11 MCOs) and FFS used administrative data. Note that many MCOs provide service to multiple Texas Medicaid managed care programs. Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,44.0,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Administrative & Hybrid,57.2,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was derived using both administrative and hybrid method data. State of Texas Access Reform (STAR) and FFS used administrative data. STAR+PLUS utilized hybrid data. Denominator is the measure-eligible population. Rate was audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,55.4,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (17 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Two data sources were used to calculate the quality of care indicators: member level enrollment information and member level health care claims/encounter data. The enrollment files contained information about the member's age, gender, the MCO, and program in which the member is enrolled per month. Member-level claims/encounter data contained CPT, ICD10-CM, and Place of Service codes, and other information necessary to calculate the quality of care indicators."" Rate was audited or validated.",Yes
Texas,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,38.4,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and managed care populations (17 MCOs). Rate was audited or validated.,Yes
Utah,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Other,Administrative,30.7,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" population included in the measure as the following: ""Denominator includes Utah Medicaid Integrated Expansion population."" The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics Medical Records: Both EHR and Paper."" Rate was audited or validated.",Yes
Utah,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid,Administrative,85.5,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated. Continuation Phase Treatment data were not collected.",Yes
Utah,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid,Administrative,NR,43,41.8,35.4,46.1,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated. Continuation Phase Treatment data were not collected.",No
Utah,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Other,Administrative,70.2,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" population included in the measure as the following: ""Denominator includes Utah Medicaid Integrated Expansion population."" The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics Medical Records: Both EHR and Paper."" Rate was audited or validated.",Yes
Utah,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Other,Administrative,16.0,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" population included in the measure as the following: ""Denominator included Utah Medicaid Integrated Expansion population."" The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated. Ages 65+ rates were not stratified.",Yes
Utah,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Other,Administrative,25.4,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" population included in the measure as the following: ""Denominator included Utah Medicaid Integrated Expansion population."" The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated. Ages 65+ rates were not stratified.",Yes
Utah,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Other,Administrative,25.7,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" population included in the measure as the following: ""Denominator includes Utah Medicaid Integrated Expansion population."" The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated. Ages 65+ rates were not stratified.",Yes
Utah,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Other,Administrative,35.7,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" population included in the measure as the following: ""Denominator includes Utah Medicaid Integrated Expansion population."" The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated. Ages 65+ rates were not stratified.",Yes
Utah,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,56.1,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",Yes
Utah,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,49.8,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",Yes
Utah,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,54.5,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rates were audited or validated.",Yes
Utah,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,37.7,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics Medical Records: Both EHR and Paper."" Denominator is the sample size; measure-eligible population is 6,140. Rate was audited or validated. Ages 65+ rate was not stratified.",Yes
Utah,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,60.3,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics Medical Records: Both EHR and Paper."" Denominator is the sample size; measure-eligible population is 6,567. Rate was audited or validated. Ages 65+ rate was not stratified.",Yes
Utah,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid,Administrative,0.8830,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics Medical Records: Both EHR and Paper."" Rates were audited or validated.",Yes
Utah,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,89.5,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Acquired Brain Injury Waiver (ABIW), Community Supports Waiver (CSW), and Utah State Developmental Center (USDC) enrollees. Funding sources include 1915(c) waivers and ICF/IID funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 5,382. The state provided the following information about the sampling or survey methodology: Simple random sample.",Yes
Utah,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,85.7,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Acquired Brain Injury Waiver (ABIW), Community Supports Waiver (CSW), and Utah State Developmental Center (USDC) enrollees. Funding sources include 1915(c) waivers and ICF/IID funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the program is 5,382. The state provided the following information about the sampling or survey methodology: Simple random sample.",Yes
Utah,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,71.7,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics Medical Records: Both EHR and Paper."" Denominator is the sample size; measure-eligible population is 6,615. Rate was audited or validated.",Yes
Utah,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid,Administrative,44.1,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rate was audited or validated.",Yes
Utah,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Hybrid,49.3,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics Medical Records: Both EHR and Paper."" Denominator is the sample size; measure-eligible population is 35,126. Rate was audited or validated.",Yes
Utah,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,45.6,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (4 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Health Plans submit independently audited HEDIS data to the Utah Office of Health Care Statistics."" Rate was audited or validated.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,80.4,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,78.6,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,65.0,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,13.3,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,72.5,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,25.0,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,34.8,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,65.4,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,72.7,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,56.0,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). The state described the ""other"" data sources used to calculate the measure as the following: ""DVHA used claims from MMIS as well as encounter data from the Vermont Department of Mental Health database."" Rates were audited or validated.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,71.9,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). The state described the ""other"" data sources used to calculate the measure as the following: ""DVHA used claims from MMIS as well as encounter data from the Vermont Department of Mental Health database."" Rates were audited or validated.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,34.3,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. State reported the following deviations: ""Our modified measure includes residential SUD treatment as initiation or engagement events where appropriate following the HEDIS specifications for sub-acute IP. When the residential SUD treatment event is the index, both index and initiation dates are set as the last day of residential SUD treatment. Our modified measure examines the start and end date of service to determine if initiation and/or treatment engagement occurs. The first month of Hub services are counted as initiation. If there is no gap in Hub services, the next month is counted as engagement."" DVHA's EQRO advised to report Medicaid Primary for administrative measures and IET visits include pharmacy. DVHA does not capture pharmacy claims for duals in a reliable manner, therefore state did not include them.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,11.5,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. State reported the following deviations: ""Our modified measure includes residential SUD treatment as initiation or engagement events where appropriate following the HEDIS specifications for sub-acute IP. When the residential SUD treatment event is the index, both index and initiation dates are set as the last day of residential SUD treatment. Our modified measure examines the start and end date of service to determine if initiation and/or treatment engagement occurs. The first month of Hub services are counted as initiation. If there is no gap in Hub services, the next month is counted as engagement."" DVHA's EQRO advised to report Medicaid Primary for administrative measures and IET visits include pharmacy. DVHA does not capture pharmacy claims for duals in a reliable manner, therefore state did not include them.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,70.3,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. State reported the following deviations: ""Our modified measure includes residential SUD treatment as initiation or engagement events where appropriate following the HEDIS specifications for sub-acute IP. When the residential SUD treatment event is the index, both index and initiation dates are set as the last day of residential SUD treatment. Our modified measure examines the start and end date of service to determine if initiation and/or treatment engagement occurs. The first month of Hub services are counted as initiation. If there is no gap in Hub services, the next month is counted as engagement."" DVHA's EQRO advised to report Medicaid Primary for administrative measures and IET visits include pharmacy. DVHA does not capture pharmacy claims for duals in a reliable manner, therefore state did not include them.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,51.2,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. State reported the following deviations: ""Our modified measure includes residential SUD treatment as initiation or engagement events where appropriate following the HEDIS specifications for sub-acute IP. When the residential SUD treatment event is the index, both index and initiation dates are set as the last day of residential SUD treatment. Our modified measure examines the start and end date of service to determine if initiation and/or treatment engagement occurs. The first month of Hub services are counted as initiation. If there is no gap in Hub services, the next month is counted as engagement."" DVHA's EQRO advised to report Medicaid Primary for administrative measures and IET visits include pharmacy. DVHA does not capture pharmacy claims for duals in a reliable manner, therefore state did not include them.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,32.7,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. State reported the following deviations: ""Our modified measure includes residential SUD treatment as initiation or engagement events where appropriate following the HEDIS specifications for sub-acute IP. When the residential SUD treatment event is the index, both index and initiation dates are set as the last day of residential SUD treatment. Our modified measure examines the start and end date of service to determine if initiation and/or treatment engagement occurs. The first month of Hub services are counted as initiation. If there is no gap in Hub services, the next month is counted as engagement."" DVHA's EQRO advised to report Medicaid Primary for administrative measures and IET visits include pharmacy. DVHA does not capture pharmacy claims for duals in a reliable manner, therefore state did not include them.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,9.7,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. State reported the following deviations: ""Our modified measure includes residential SUD treatment as initiation or engagement events where appropriate following the HEDIS specifications for sub-acute IP. When the residential SUD treatment event is the index, both index and initiation dates are set as the last day of residential SUD treatment. Our modified measure examines the start and end date of service to determine if initiation and/or treatment engagement occurs. The first month of Hub services are counted as initiation. If there is no gap in Hub services, the next month is counted as engagement."" DVHA's EQRO advised to report Medicaid Primary for administrative measures and IET visits include pharmacy. DVHA does not capture pharmacy claims for duals in a reliable manner, therefore state did not include them.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,44.2,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. State reported the following deviations: ""Our modified measure includes residential SUD treatment as initiation or engagement events where appropriate following the HEDIS specifications for sub-acute IP. When the residential SUD treatment event is the index, both index and initiation dates are set as the last day of residential SUD treatment. Our modified measure examines the start and end date of service to determine if initiation and/or treatment engagement occurs. The first month of Hub services are counted as initiation. If there is no gap in Hub services, the next month is counted as engagement."" DVHA's EQRO advised to report Medicaid Primary for administrative measures and IET visits include pharmacy. DVHA does not capture pharmacy claims for duals in a reliable manner, therefore state did not include them.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,23.6,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. State reported the following deviations: ""Our modified measure includes residential SUD treatment as initiation or engagement events where appropriate following the HEDIS specifications for sub-acute IP. When the residential SUD treatment event is the index, both index and initiation dates are set as the last day of residential SUD treatment. Our modified measure examines the start and end date of service to determine if initiation and/or treatment engagement occurs. The first month of Hub services are counted as initiation. If there is no gap in Hub services, the next month is counted as engagement."" DVHA's EQRO advised to report Medicaid Primary for administrative measures and IET visits include pharmacy. DVHA does not capture pharmacy claims for duals in a reliable manner, therefore state did not include them.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,72.5,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA does not have an age breakout for these rates. The rate for ages 18-64 includes ages 18+.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,62.0,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA does not have an age breakout for these rates. The rate for ages 18-64 includes ages 18+.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid & CHIP,CAHPS 5.1H,59.4,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA does not have an age breakout for these rates. The rate for ages 18-64 includes ages 18+.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,11.9,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,90.3,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,45.8,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,61.2,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,49.5,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rates were audited or validated. DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,40.6,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,46.2,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Denominator is the sample size; measure-eligible population is 8,437. Rate was audited or validated. The age group of 65-74 was not separately sampled for hybrid measures so rate for ages 18-64 includes ages 18+.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,52.1,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Denominator is the sample size; measure-eligible population is 10,606. The age group of 65-74 was not separately sampled for hybrid measures so the rate for ages 18-64 includes ages 18+.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,1.0328,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,13.5,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & CHIP,Administrative,25.0,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,14.6,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,DS,33,3.1,4.7,2.2,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",No
Vermont,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,15.2,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,7.8,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,8.6,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,33.0,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,3.0,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,21.4,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Vermont,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,82.7,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Denominator is the sample size; measure-eligible population is 1,956. Rate was audited or validated.",Yes
Vermont,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,46.4,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rate was audited or validated. DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Administrative,50.1,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,52.0,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan). Rate was audited or validated. DVHA's EQRO advised to report Medicaid Primary for administrative measures.",Yes
Vermont,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,33.8,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes ""other"" delivery system (Vermont Medicaid is operated under managed care as a public non-risk prepaid inpatient health plan).",Yes
Virginia,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,62.8,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rate was audited or validated. The data reported is the total Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,62.4,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,45.4,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,79.3,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,14.1,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,22.2,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,37.6,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,50.9,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,27.3,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,48.3,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,43.6,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,10.6,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,68.2,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,43.0,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,44.8,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,11.1,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,48.4,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,18.0,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,73.9,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,51.8,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates, which is the age range of 18 and older.",Yes
Virginia,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,44.1,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). Rates were audited or validated. The data reported are the Quality Compass HEDIS measure rates, which is the age range of 18 and older.",Yes
Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,65.3,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 19-50 and 51- 64 as the age stratifications. There is no Total rate for ages 19 to 64.",Yes
Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,66.6,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 19-50 and 51- 64 as the age stratifications. There is no Total rate for ages 19 to 64.",Yes
Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,NR,45,57.9,53.1,62.4,NR = State did not report the measure for this population,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 19-50 and 51- 64 as the age stratifications. There is no Total rate for ages 19 to 64.",No
Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,40.8,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rate was audited or validated.",Yes
Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,49.7,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology."" Sample size and measure-eligible population are not available. Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18 to 75 years.",Yes
Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,50.2,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology."" Sample size and measure-eligible population are not available. Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 18-85.",Yes
Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,0.8811,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rates were audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,90.7,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Building Independence Waiver, Family & Individual Supports Waiver, and Community Living Waiver enrollees. Funding source includes 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 15,322. The state provided the following information about the sampling or survey methodology: Proportionate by health planning region. Individuals on the Elderly or Disabled w/Consumer Direction (EDCD) Waiver, in ICF/IIDs, or in nursing facilities are excluded from this sample.",Yes
Virginia,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,95.4,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Building Independence Waiver, Family & Individual Supports Waiver, and Community Living Waiver enrollees. Funding source includes 1915(c) waivers. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 15,322. The state provided the following information about the sampling or survey methodology: Proportionate by health planning region. Individuals on the Elderly or Disabled w/Consumer Direction (EDCD) Waiver, in ICF/IIDs, or in nursing facilities are excluded from this sample.",Yes
Virginia,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,68.0,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology."" Sample size and measure-eligible population are not available. Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,46.4,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate, which is the age range of 50-74.",Yes
Virginia,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",Hybrid,49.8,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the hybrid methodology."" Sample size and measure-eligible population are not available. Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,"Medicaid, CHIP, & Dual Eligibles",Administrative,58.6,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (6 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""Virginia used the audited HEDIS rates from Quality Compass to report this measure; the six MCOs used the administrative methodology."" Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate.",Yes
Virginia,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,"Medicaid, CHIP, & Dual Eligibles",CAHPS 5.1H,40.7,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (6 MCOs). Rate was audited or validated. The data reported is the Quality Compass HEDIS measure rate.,Yes
Washington,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,62.7,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,63.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,45.8,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,10.6,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,77.8,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS and PCCM populations.,Yes
Washington,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,22.5,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,31.5,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,52.3,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,64.2,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,46.1,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,65.0,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,34.5,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,10.8,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,64.5,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,33.8,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,34.3,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,8.3,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,41.8,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,15.9,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & CHIP,Administrative,6.8,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,76.7,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,60.5,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,62.9,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,61.2,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,42.4,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (5 MCOs). Rate was audited or validated.,Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,37.6,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 55,364. Rate was audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,Hybrid,63.9,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 63,520. Rate was audited or validated. The Ages 18 to 64 rate includes individuals age 18 and older.",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,0.8437,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,13.2,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & CHIP,Administrative,15.5,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,24.4,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & CHIP,Administrative,3.1,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,24.0,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full-third party liability."" State reported the following deviations: ""Used GPI instead of NDC to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,5.2,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full-third party liability."" State reported the following deviations: ""Used GPI instead of NDC to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Specifications instruct to include all paid, suspended, pending, and denied claims. We report using a data source of paid claims. The only denied claims included are denied lines from otherwise accepted encounters.""",Yes
Washington,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,8.2,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Reported using paid claims. The only denied claims included are denied lines from otherwise accepted encounters. We used procedure code dates for delivery dates instead of the ICD-10 codes as they were more accurate when compared with birth certificate dates. Did not use the global OB code 59400 to identify births if it was paired with a diagnosis code for encounter for supervision of a pregnancy of less than 19 weeks gestation as this misidentified prenatal care as births.""",Yes
Washington,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,36.0,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Reported using paid claims. The only denied claims included are denied lines from otherwise accepted encounters. We used procedure code dates for delivery dates instead of the ICD-10 codes as they were more accurate when compared with birth certificate dates. Did not use the global OB code 59400 to identify births if it was paired with a diagnosis code for encounter for supervision of a pregnancy of less than 19 weeks gestation as this misidentified prenatal care as births.""",Yes
Washington,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,0.8,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Reported using paid claims. The only denied claims included are denied lines from otherwise accepted encounters. We used procedure code dates for delivery dates instead of the ICD-10 codes as they were more accurate when compared with birth certificate dates. Did not use the global OB code 59400 to identify births if it was paired with a diagnosis code for encounter for supervision of a pregnancy of less than 19 weeks gestation as this misidentified prenatal care as births.""",Yes
Washington,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & CHIP,Administrative,13.3,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS, PCCM and managed care populations (5 MCOs). State reported that rates exclude the following populations: ""Dual Medicaid/Medicare eligibles and those with full third-party liability."" State reported the following deviations: ""Used GPI to identify the applicable NDCs for specific methods. Did not use S4993 alone as indication of oral contraception, as WA also uses S4993 to indicate emergency contraception. Required FP modifier for 11981 and 11983 to verify contraceptive use (as required by WA). Reported using paid claims. The only denied claims included are denied lines from otherwise accepted encounters. We used procedure code dates for delivery dates instead of the ICD-10 codes as they were more accurate when compared with birth certificate dates. Did not use the global OB code 59400 to identify births if it was paired with a diagnosis code for encounter for supervision of a pregnancy of less than 19 weeks gestation as this misidentified prenatal care as births.""",Yes
Washington,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Hybrid,79.3,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (5 MCOs). Denominator is the sample size; measure-eligible population is 24,426.",Yes
Washington,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative,43.6,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Administrative,47.0,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
Washington,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative,55.1,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS, PCCM and managed care populations (5 MCOs).",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & Dual Eligibles,Administrative,61.4,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,68.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Age can be adjusted as long as age range was not changed or expanded. The Age range was defined with a relative date of 8 months from the end of the prior measurement year to 8 months prior to the end of the current measurement year. Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,50.2,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Age can be adjusted as long as age range was not changed or expanded. The Age range was defined with a relative date of 8 months from the end of the prior measurement year to 8 months prior to the end of the current measurement year. Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,2.7,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Includes paid claims only.""",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,76.0,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Age can be adjusted as long as age range was not changed on expanded. Age was defined based on the start of the measurement year.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,51.7,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age is as of admission but the age groups were defined by end of measurement period; continuous enrollment was adjusted as most health plans do not carve out chemical dependency, so this requirement was dropped; the rates evaluate only the first two events to meet the allowable adjustment criteria; no restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,59.5,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age is as of admission but the age groups were defined by end of measurement period; continuous enrollment was adjusted as most health plans do not carve out chemical dependency, so this requirement was dropped; the rates evaluate only the first two events to meet the allowable adjustment criteria; no restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & Dual Eligibles,Administrative,3.5,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Includes paid claims only.""",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,12.4,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Includes paid claims only.""",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,15.0,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Includes paid claims only.""",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,22.8,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviation: ""Includes paid claims only.""",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,41.6,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" West Virginia Medicaid has an 1115 waiver targeting substance use disorder that began in calendar year 2018. Medication assisted treatment (MAT) for WV Medicaid members require therapeutic intervention to begin & continue MAT. The state's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age was defined based on the end of measurement year (MY); numerator period is set to a relative time from the beginning of the MY to 47 days prior to the end of the MY; no restrictions on data type for the files that are submitted for processing; most claims data did not identify MHSA coverage & included it under medical coverage so eligibility was defined using medical coverage.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,13.1,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" West Virginia Medicaid has an 1115 waiver targeting substance use disorder that began in calendar year 2018. Medication assisted treatment (MAT) for WV Medicaid members require therapeutic intervention to begin & continue MAT. The state's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age was defined based on the end of measurement year (MY); numerator period is set to a relative time from the beginning of the MY to 47 days prior to the end of the MY; no restrictions on data type for the files that are submitted for processing; most claims data did not identify MHSA coverage & included it under medical coverage so eligibility was defined using medical coverage.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,70.8,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" West Virginia Medicaid has an 1115 waiver targeting substance use disorder that began in calendar year 2018. Medication assisted treatment (MAT) for WV Medicaid members require therapeutic intervention to begin & continue MAT. The state's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age was defined based on the end of measurement year (MY); numerator period is set to a relative time from the beginning of the MY to 47 days prior to the end of the MY; no restrictions on data type for the files that are submitted for processing; most claims data did not identify MHSA coverage & included it under medical coverage so eligibility was defined using medical coverage.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,48.7,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" West Virginia Medicaid has an 1115 waiver targeting substance use disorder that began in calendar year 2018. Medication assisted treatment (MAT) for WV Medicaid members require therapeutic intervention to begin & continue MAT. The state's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age was defined based on the end of measurement year (MY); numerator period is set to a relative time from the beginning of the MY to 47 days prior to the end of the MY; no restrictions on data type for the files that are submitted for processing; most claims data did not identify MHSA coverage & included it under medical coverage so eligibility was defined using medical coverage.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,44.7,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" West Virginia Medicaid has an 1115 waiver targeting substance use disorder that began in calendar year 2018. Medication assisted treatment (MAT) for WV Medicaid members require therapeutic intervention to begin & continue MAT. The state's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age was defined based on the end of measurement year (MY); numerator period is set to a relative time from the beginning of the MY to 47 days prior to the end of the MY; no restrictions on data type for the files that are submitted for processing; most claims data did not identify MHSA coverage & included it under medical coverage so eligibility was defined using medical coverage.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,16.4,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" West Virginia Medicaid has an 1115 waiver targeting substance use disorder that began in calendar year 2018. Medication assisted treatment (MAT) for WV Medicaid members require therapeutic intervention to begin & continue MAT. The state's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age was defined based on the end of measurement year (MY); numerator period is set to a relative time from the beginning of the MY to 47 days prior to the end of the MY; no restrictions on data type for the files that are submitted for processing; most claims data did not identify MHSA coverage & included it under medical coverage so eligibility was defined using medical coverage.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,52.1,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" West Virginia Medicaid has an 1115 waiver targeting substance use disorder that began in calendar year 2018. Medication assisted treatment (MAT) for WV Medicaid members require therapeutic intervention to begin & continue MAT. The state's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age was defined based on the end of measurement year (MY); numerator period is set to a relative time from the beginning of the MY to 47 days prior to the end of the MY; no restrictions on data type for the files that are submitted for processing; most claims data did not identify MHSA coverage & included it under medical coverage so eligibility was defined using medical coverage.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,26.7,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" West Virginia Medicaid has an 1115 waiver targeting substance use disorder that began in calendar year 2018. Medication assisted treatment (MAT) for WV Medicaid members require therapeutic intervention to begin & continue MAT. The state's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: age was defined based on the end of measurement year (MY); numerator period is set to a relative time from the beginning of the MY to 47 days prior to the end of the MY; no restrictions on data type for the files that are submitted for processing; most claims data did not identify MHSA coverage & included it under medical coverage so eligibility was defined using medical coverage.",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Advised to Quit: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,73.1,27,72.6,64.6,74.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
West Virginia,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Recommended Cessation Medications: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,49.7,27,49.9,46.1,57.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
West Virginia,Behavioral Health Care,Adult Core Set,Medical Assistance With Smoking and Tobacco Use Cessation: Age 18 and older,MSC-AD,Higher rates are better for this measure,Percentage of Current Smokers and Tobacco Users Discussed or Provided Other Cessation Strategies: Ages 18 to 64 Years,2022,Medicaid,CAHPS 5.1H,44.9,27,44.2,40.5,49.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include managed care population (3 MCOs). Rates were audited or validated.,Yes
West Virginia,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,9.8,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,71.0,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid,Administrative,33.8,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid,Administrative,37.2,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid,Administrative,34.7,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rates were audited or validated.",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,38.3,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Age was based on the end of the measurement year; rate evaluates only the first two events to meet the allowable adjustment criteria; denominator period is set to a relative time from the 18-month prior to 6-months from the measurement period end date.",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%): Ages 18 to 75,HPC-AD,Lower rates are better for this measure,Percentage with Diabetes (Type 1 or Type 2) who had Hemoglobin A1c in Poor Control (>9.0%): Ages 18 to 64,2022,Medicaid,Hybrid,37.4,33,41.2,48.9,36.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""EQRO compilation of the State's three MCOs HEDIS reports. The three MCOs are NCQA certified for HEDIS reporting."" Denominator is the sample size; measure-eligible population is 26,338. Rate was audited or validated. The three MCOs are NCQA certified for HEDIS reporting.",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid,Hybrid,62.1,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 45,946. Rate was audited or validated.",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,0.8523,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,12.8,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviations: ""Members are included in the denominator if their age falls within the stated range during the reporting time period; age is determined in the denominator and not at the time of a hospital admission; rates do not exclude beneficiaries with missing sex, age, quarter, year; principal diagnosis, or county; calculations do not include a check of prior admits for type of transfer Point of Origin.""",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & Dual Eligibles,Administrative,29.8,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviations: ""Members are included in the denominator if their age falls within the stated range during the reporting time period; age is determined in the denominator and not at the time of a hospital admission; rates do not exclude beneficiaries with missing sex, age, quarter, year; principal diagnosis, or county; calculations do not include a check of prior admits for type of transfer Point of Origin.""",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,21.8,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviations: ""Members are included in the denominator if their age falls within the stated range during the reporting time period; age is determined in the denominator and not at the time of a hospital admission; rates do not exclude beneficiaries with missing sex, age, quarter, year; principal diagnosis, or county; calculations do not include a check of prior admits for type of transfer Point of Origin.""",Yes
West Virginia,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & Dual Eligibles,Administrative,1.2,33,3.1,4.7,2.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" State reported the following deviations: ""Members are included in the denominator if their age falls within the stated range during the reporting time period; age is determined in the denominator and not at the time of a hospital admission; rates do not exclude beneficiaries with missing sex, age, quarter, year; principal diagnosis, or county; calculations do not include a check of prior admits for type of transfer Point of Origin.""",Yes
West Virginia,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,21.7,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,2.9,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,16.2,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,43.0,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,2.3,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,8.5,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS.""",Yes
West Virginia,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid,Hybrid,75.3,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 7,981. Rate was audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,40.6,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes FFS and managed care populations (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""State's Data Warehouse, separate from the MMIS."" The State's Data Warehouse vendor is certified by HEDIS for this measure. The logic includes the following allowable adjustments: Age can be adjusted as long as age range was not changed or expanded. Age was defined based on the end of measurement year. Organizations are not required to limit criteria for supplemental data or denied data. All data has been used when evaluating eligible population, numerator, and exclusion criteria. No restrictions on data type for the files that are submitted for processing.",Yes
West Virginia,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid,Hybrid,44.6,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Denominator is the sample size; measure-eligible population is 125,211. Rate was audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid,Administrative,53.3,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (3 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""MCO Claims Systems."" Rate was audited or validated.",Yes
West Virginia,Primary Care Access and Preventive Care,Adult Core Set,Flu Vaccinations for Adults Ages 18 to 64,FVA-AD,Higher rates are better for this measure,Percentage who Received a Flu Vaccination: Ages 18 to 64,2022,Medicaid,CAHPS 5.1H,32.3,28,40.5,35.4,46.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes managed care population (3 MCOs). Rate was audited or validated.,Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Adherence to Antipsychotic Medications for Individuals with Schizophrenia: Age 18 and older,SAA-AD,Higher rates are better for this measure,Percentage with Schizophrenia or Schizoaffective Disorder who were Dispensed and Remained on Antipsychotic Medication for at Least 80 Percent of their Treatment Period: Age 18 and older,2022,Medicaid & CHIP,Administrative,56.3,46,62.2,56.8,67.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,72.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,53.5,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications: Ages 18 to 64,SSD-AD,Higher rates are better for this measure,"Percentage with Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder who were Dispensed an Antipsychotic Medication and had a Diabetes Screening Test: Ages 18 to 64",2022,Medicaid & CHIP,Administrative,75.8,46,77.1,74.2,78.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,17.4,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,26.9,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & CHIP,Administrative,39.0,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,52.1,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,40.4,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,59.2,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,40.9,45,42.1,39.2,45.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,13.3,45,12.2,8.1,14.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,60.4,43,56.6,50.1,64.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Opioid Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,38.0,43,29.5,17.5,37.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,38.1,43,41.3,36.9,44.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,9.7,43,11.0,7.9,15.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated Alcohol or Other Drug Treatment within 14 Days of the Diagnosis: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,41.9,44,43.4,41.0,47.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Behavioral Health Care,Adult Core Set,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment: Age 18 and Older,IET-AD,Higher rates are better for this measure,Percentage with a New Episode of Alcohol or Other Drug Abuse or Dependence who Initiated and Engaged in Alcohol or Other Drug Treatment within 34 Days of the Initiation Visit: Ages 18 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,15.7,44,15.8,10.5,18.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & CHIP,Administrative,59.0,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & CHIP,Administrative,65.1,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & CHIP,Administrative,60.2,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Care of Acute and Chronic Conditions,Adult Core Set,Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis: Age 18 and Older,AAB-AD,Higher rates are better for this measure,Percentage of Episodes for Beneficiaries with a Diagnosis of Acute Bronchitis/Bronchiolitis that did not Result in an Antibiotic Dispensing Event: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,56.1,34,43.3,40.1,54.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was audited or validated.",Yes
Wisconsin,Care of Acute and Chronic Conditions,Adult Core Set,Controlling High Blood Pressure: Ages 18 to 85,CBP-AD,Higher rates are better for this measure,Percentage who had a Diagnosis of Hypertension and Whose Blood Pressure was Adequately Controlled: Ages 18 to 64,2022,Medicaid & CHIP,"Administrative, Electronic Health Records, & Hybrid",59.0,38,57.7,52.1,62.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was derived using administrative data, hybrid method data, and EHR data. The measure-eligible population is not available. Rate was audited or validated.",Yes
Wisconsin,Care of Acute and Chronic Conditions,Adult Core Set,Plan All-Cause Readmissions: Ages 18 to 64,PCR-AD,Lower rates are better for this measure,Ratio of Observed All-Cause Readmissions to Expected Readmissions: Ages 18 to 64,2022,Medicaid & CHIP,Administrative,0.9547,39,0.9752,1.1244,0.8998,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rates include managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rates were audited or validated.",Yes
Wisconsin,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,"Percentage of Adults who Reported They Decided or Had Help Deciding Their Daily Schedule, How to Spend Money, and How to Spend Free Time",2022,Medicaid,NCI In-Person Survey,84.9,27,90.7,89.1,94.4,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Family Care Waiver, Partnership, and Include, Respect, I Self-Direct (IRIS) enrollees. Funding sources include 1915(c) waivers, a combination 1915(b)/(c) waiver, a 1915(j) state plan option, and 1932(a) state plan funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 32,906. The state provided the following information about the sampling or survey methodology: Proportionate by program. Individuals who participated in the 2020-2021 survey cycle and people who requested to be on a ""no call"" list are excluded from this sample.",Yes
Wisconsin,Long-Term Services and Supports,Adult Core Set,National Core Indicators Survey: Age 18 and Older,NCIDDS-AD,Higher rates are better for this measure,Percentage of Adults who Reported They Always Have a Way to Get Places When They Need to go Somewhere,2022,Medicaid,NCI In-Person Survey,88.5,27,94.5,89.8,96.7,,"Mathematica analysis of National Core Indicators (NCI) data submitted by states to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) (The NCI National Team) through the Online Data Entry System (ODESA) for the July 1, 2021 to June 30, 2022 data collection period, corresponding to the FFY 2022 reporting cycle, as of May 5, 2023.","Rates include Family Care Waiver, Partnership, and Include, Respect, I Self-Direct (IRIS) enrollees. Funding sources include 1915(c) waivers, a combination 1915(b)/(c) waiver, a 1915(j) state plan option, and 1932(a) state plan funding. Denominator is the number of enrollees who responded to the questions. Total number of enrollees included in the programs is 32,906. The state provided the following information about the sampling or survey methodology: Proportionate by program. Individuals who participated in the 2020-2021 survey cycle and people who requested to be on a ""no call"" list are excluded from this sample.",Yes
Wisconsin,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & CHIP,Administrative & Hybrid,78.2,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rate was audited or validated. State uses standardized denominators to calculate the state average, which is based on aggregated denominators that may represent sample or eligible population results. Unfortunately, at this time, the state does not have the resources to differentiate between these two types of denominators.",Yes
Wisconsin,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & CHIP,Administrative & Electronic Health Records,53.8,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was audited or validated.",Yes
Wisconsin,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & CHIP,Administrative & Hybrid,63.4,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was derived using both administrative and hybrid method data. Denominator is the measure-eligible population. Rate was audited or validated. State uses standardized denominators to calculate the state average, which is based on aggregated denominators that may represent sample or eligible population results. Unfortunately, at this time, the state does not have the resources to differentiate between these two types of denominators.",Yes
Wisconsin,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & CHIP,Administrative & Electronic Health Records,59.5,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.","Rate includes managed care population (14 MCOs). The state described the ""other"" data sources used to calculate the measure as the following: ""HMO Claim System."" Rate was audited or validated.",Yes
Wyoming,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 12 Weeks: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,46.0,44,58.8,54.6,64.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Antidepressant Medication Management: Age 18 and Older,AMM-AD,Higher rates are better for this measure,Percentage Diagnosed with Major Depression who were Treated with and Remained on Antidepressant Medication for 6 Months: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,18.9,43,41.8,35.4,46.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Concurrent Use of Opioids and Benzodiazepines: Age 18 and older,COB-AD,Lower rates are better for this measure,Percentage with Concurrent Use of Prescription Opioids and Benzodiazepines: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,1.0,36,13.3,16.0,9.7,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,13.5,47,15.5,10.9,19.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: Age 18 and Older,FUA-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Alcohol and Other Drug Abuse or Dependence with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,23.7,47,23.8,15.5,29.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days of the ED Visit: Ages 18 to 64 ,2022,Medicaid & Dual Eligibles,Administrative,32.6,48,38.9,29.2,52.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older,FUM-AD,Higher rates are better for this measure,Percentage of Emergency Department (ED) Visits for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days of the ED Visit: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,52.0,48,52.5,42.9,63.5,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 7 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,36.2,46,33.9,28.6,43.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Follow-Up After Hospitalization for Mental Illness: Age 18 and Older,FUH-AD,Higher rates are better for this measure,Percentage of Hospitalizations for Mental Illness or Intentional Self-Harm with a Follow-Up Visit Within 30 Days after Discharge: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,63.8,46,54.5,48.3,64.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Use of Opioids at High Dosage in Persons Without Cancer: Age 18 and Older,OHD-AD,Lower rates are better for this measure,Percentage of Adults Without Cancer who Received Prescriptions for Opioids with an Average Daily Dosage Greater than or Equal to 90 Morphine Milligram Equivalents (MME) for a Period of 90 Days or More: Ages 18 to 64 Years,2022,Medicaid & Dual Eligibles,Administrative,19.8,32,6.7,9.0,3.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Behavioral Health Care,Adult Core Set,Use of Pharmacotherapy for Opioid Use Disorder: Ages 18 to 64,OUD-AD,Higher rates are better for this measure,Percentage with an Opioid Use Disorder who Filled a Prescription for or were Administered or Dispensed an FDA-Approved Medication for the Disorder: Total Rate: Ages 18 to 64,2022,Medicaid & Dual Eligibles,Administrative,34.0,33,56.2,51.6,71.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 50,2022,Medicaid & Dual Eligibles,Administrative,29.5,45,57.8,53.8,63.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 51 to 64,2022,Medicaid & Dual Eligibles,Administrative,45.0,45,58.0,53.4,62.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Care of Acute and Chronic Conditions,Adult Core Set,Asthma Medication Ratio: Ages 19 to 64,AMR-AD,Higher rates are better for this measure,Percentage with Persistent Asthma who had a Ratio of Controller Medications to Total Asthma Medications of 0.50 or Greater: Ages 19 to 64,2022,Medicaid & Dual Eligibles,Administrative,33.5,45,57.9,53.1,62.4,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Care of Acute and Chronic Conditions,Adult Core Set,PQI 01: Diabetes Short-Term Complications Admission Rate: Age 18 and Older,PQI01-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Diabetes Short-Term Complications per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,14.3,38,17.2,21.8,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Care of Acute and Chronic Conditions,Adult Core Set,PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate: Age 40 and Older,PQI05-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma per 100,000 Beneficiary Months: Ages 40 to 64",2022,Medicaid & Dual Eligibles,Administrative,21.5,34,29.8,40.6,23.2,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Care of Acute and Chronic Conditions,Adult Core Set,PQI 08: Heart Failure Admission Rate: Age 18 and Older,PQI08-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Heart Failure per 100,000 Beneficiary Months: Ages 18 to 64",2022,Medicaid & Dual Eligibles,Administrative,5.2,34,23.9,33.4,17.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Care of Acute and Chronic Conditions,Adult Core Set,PQI 15: Asthma in Younger Adults Admission Rate: Ages 18 to 39,PQI15-AD,Lower rates are better for this measure,"Inpatient Hospital Admissions for Asthma per 100,000 Beneficiary Months: Ages 18 to 39",2022,Medicaid & Dual Eligibles,Administrative,DS,33,3.1,4.7,2.2,"DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services' cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.","Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,No
Wyoming,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Most Effective or Moderately Effective Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,15.7,39,23.9,21.2,25.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: All Women Ages 21 to 44,CCW-AD,Higher rates are better for this measure,Percentage of Women at Risk for Unintended Pregnancy Provided a Long-Acting Reversible Method of Contraception: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,6.0,39,4.3,3.5,5.8,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,13.6,39,11.7,8.7,13.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Most Effective or Moderately Effective Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,22.4,39,38.6,34.1,41.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 3 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,1.5,37,2.1,0.9,3.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Adult Core Set,Contraceptive Care: Postpartum Women Ages 21 to 44,CCP-AD,Higher rates are better for this measure,Percentage of Postpartum Women Provided a Long-Acting Reversible Method of Contraception Within 60 Days of Delivery: Ages 21 to 44,2022,Medicaid & Dual Eligibles,Administrative,14.6,39,11.7,9.1,13.9,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rates include FFS population.,Yes
Wyoming,Maternal and Perinatal Health,Adult Core Set,Prenatal and Postpartum Care: Postpartum Care,PPC-AD,Higher rates are better for this measure,Percentage of Women Delivering a Live Birth who had a Postpartum Care Visit on or Between 7 and 84 Days after Delivery,2022,Medicaid & Dual Eligibles,Administrative,53.3,44,75.0,65.1,78.6,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Adult Core Set,Breast Cancer Screening: Ages 50 to 74,BCS-AD,Higher rates are better for this measure,Percentage of Women who had a Mammogram to Screen for Breast Cancer: Ages 50 to 64,2022,Medicaid & Dual Eligibles,Administrative,31.2,46,48.8,43.6,54.0,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Adult Core Set,Cervical Cancer Screening: Ages 21 to 64,CCS-AD,Higher rates are better for this measure,Percentage of Women Screened for Cervical Cancer: Ages 21 to 64,2022,Medicaid & Dual Eligibles,Administrative,31.3,46,51.4,44.6,58.3,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes
Wyoming,Primary Care Access and Preventive Care,Adult Core Set,Chlamydia Screening in Women Ages 21 to 24,CHL-AD,Higher rates are better for this measure,Percentage of Sexually Active Women Screened for Chlamydia: Ages 21 to 24,2022,Medicaid & Dual Eligibles,Administrative,32.5,46,55.9,52.0,64.1,,"Mathematica analysis of the Quality Measure Reporting (QMR) system reports for the FFY 2022 reporting cycle as of June 1, 2023.",Rate includes FFS population.,Yes