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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 | 2,022 | Medicaid | CAHPS 5.1H | 40.9 | 27 | 49.9 | 46.1 | 57.7 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | CAHPS 5.1H | 35.6 | 27 | 44.2 | 40.5 | 49.3 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 63.9 | 45 | 57.8 | 53.8 | 63.1 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 68.5 | 45 | 58 | 53.4 | 62.9 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 65.3 | 45 | 57.9 | 53.1 | 62.4 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 43.0 | 34 | 43.3 | 40.1 | 54.4 | null | Mathematica analysis 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 | 2,022 | Medicaid | Hybrid | 52.6 | 33 | 41.2 | 48.9 | 36.8 | null | Mathematica analysis 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... | 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 | 2,022 | Medicaid | Hybrid | 49.6 | 38 | 57.7 | 52.1 | 62.1 | null | Mathematica analysis 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... | 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 | 2,022 | Medicaid | Administrative | 0.6870 | 39 | 0.9752 | 1.1244 | 0.8998 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 17.5 | 38 | 17.2 | 21.8 | 13.6 | null | Mathematica analysis 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-Elig... | 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 | 2,022 | Medicaid | Hybrid | 65.7 | 44 | 75 | 65.1 | 78.6 | null | Mathematica analysis 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 | 2,022 | Medicaid | Administrative | 36.1 | 46 | 48.8 | 43.6 | 54 | null | Mathematica analysis 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 meas... | 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 | 2,022 | Medicaid | Administrative & Hybrid | 44.0 | 46 | 51.4 | 44.6 | 58.3 | null | Mathematica analysis 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-eli... | 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 | 2,022 | Medicaid | Administrative | 54.9 | 46 | 55.9 | 52 | 64.1 | null | Mathematica analysis 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 | 2,022 | Medicaid | CAHPS 5.1H | 40.2 | 28 | 40.5 | 35.4 | 46.4 | null | Mathematica analysis 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 | 2,022 | Medicaid | Administrative | 64.9 | 46 | 62.2 | 56.8 | 67.1 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 56.9 | 44 | 58.8 | 54.6 | 64 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 41.8 | 43 | 41.8 | 35.4 | 46.1 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 16.4 | 36 | 13.3 | 16 | 9.7 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 75.7 | 46 | 77.1 | 74.2 | 78.5 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 21.3 | 47 | 15.5 | 10.9 | 19.1 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 27.4 | 47 | 23.8 | 15.5 | 29 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 61.0 | 48 | 38.9 | 29.2 | 52.6 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 70.7 | 48 | 52.5 | 42.9 | 63.5 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 51.4 | 46 | 33.9 | 28.6 | 43.3 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 66.6 | 46 | 54.5 | 48.3 | 64.9 | null | Mathematica analysis of the 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 | 2,022 | Medicaid & Dual Eligibles | Administrative | 47.2 | 45 | 42.1 | 39.2 | 45.5 | null | Mathematica analysis 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 | 2,022 | Medicaid & Dual Eligibles | Administrative | 15.9 | 45 | 12.2 | 8.1 | 14.4 | null | Mathematica analysis 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 | 2,022 | Medicaid & Dual Eligibles | Administrative | 65.4 | 43 | 56.6 | 50.1 | 64.6 | null | Mathematica analysis 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 | 2,022 | Medicaid & Dual Eligibles | Administrative | 35.5 | 43 | 29.5 | 17.5 | 37.4 | null | Mathematica analysis 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 | 2,022 | Medicaid & Dual Eligibles | Administrative | 50.2 | 43 | 41.3 | 36.9 | 44.8 | null | Mathematica analysis 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 | 2,022 | Medicaid & Dual Eligibles | Administrative | 16.6 | 43 | 11 | 7.9 | 15.1 | null | Mathematica analysis 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 | 2,022 | Medicaid & Dual Eligibles | Administrative | 49.1 | 44 | 43.4 | 41 | 47.7 | null | Mathematica analysis 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 | 2,022 | Medicaid & Dual Eligibles | Administrative | 18.9 | 44 | 15.8 | 10.5 | 18.5 | null | Mathematica analysis 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 | 2,022 | Medicaid | CAHPS 5.1H | 82.4 | 27 | 72.6 | 64.6 | 74.4 | null | Mathematica analysis 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 | 2,022 | Medicaid | CAHPS 5.1H | 67.4 | 27 | 49.9 | 46.1 | 57.7 | null | Mathematica analysis 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 | 2,022 | Medicaid | CAHPS 5.1H | 59.6 | 27 | 44.2 | 40.5 | 49.3 | null | Mathematica analysis 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 | 2,022 | Medicaid | Administrative | 65.2 | 33 | 56.2 | 51.6 | 71 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 49.2 | 45 | 57.8 | 53.8 | 63.1 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 50.3 | 45 | 58 | 53.4 | 62.9 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 49.6 | 45 | 57.9 | 53.1 | 62.4 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 45.3 | 34 | 43.3 | 40.1 | 54.4 | null | Mathematica analysis 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 | 2,022 | Medicaid | Hybrid | 35.8 | 33 | 41.2 | 48.9 | 36.8 | null | Mathematica analysis 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 | 2,022 | Medicaid | Hybrid | 64.0 | 38 | 57.7 | 52.1 | 62.1 | null | Mathematica analysis 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 | 2,022 | Medicaid | Administrative | 0.9598 | 39 | 0.9752 | 1.1244 | 0.8998 | null | Mathematica analysis 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 | 2,022 | Medicaid | Administrative | 11.4 | 38 | 17.2 | 21.8 | 13.6 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 27.8 | 34 | 29.8 | 40.6 | 23.2 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 17.1 | 34 | 23.9 | 33.4 | 17.1 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 4.9 | 33 | 3.1 | 4.7 | 2.2 | null | Mathematica 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 | 2,022 | Medicaid | NCI In-Person Survey | 86.3 | 27 | 90.7 | 89.1 | 94.4 | null | 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 Ju... | 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... | 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 | 2,022 | Medicaid | NCI In-Person Survey | 91.8 | 27 | 94.5 | 89.8 | 96.7 | null | 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 Ju... | 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... | 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 | 2,022 | Medicaid | Administrative | 23.6 | 39 | 23.9 | 21.2 | 25.9 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 3.5 | 39 | 4.3 | 3.5 | 5.8 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 12.5 | 39 | 11.7 | 8.7 | 13.6 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 37.5 | 39 | 38.6 | 34.1 | 41.3 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 4.4 | 37 | 2.1 | 0.9 | 3 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 10.5 | 39 | 11.7 | 9.1 | 13.9 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Hybrid | 76.5 | 44 | 75 | 65.1 | 78.6 | null | Mathematica analysis 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 | 2,022 | Medicaid | Administrative | 57.6 | 46 | 48.8 | 43.6 | 54 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 54.5 | 46 | 51.4 | 44.6 | 58.3 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 68.5 | 46 | 55.9 | 52 | 64.1 | null | Mathematica 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 | 2,022 | Medicaid | CAHPS 5.1H | 49.4 | 28 | 40.5 | 35.4 | 46.4 | null | Mathematica analysis 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 | 2,022 | Medicaid | Administrative | 64.0 | 46 | 62.2 | 56.8 | 67.1 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 54.1 | 44 | 58.8 | 54.6 | 64 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 33.9 | 43 | 41.8 | 35.4 | 46.1 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 13.1 | 36 | 13.3 | 16 | 9.7 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 77.1 | 46 | 77.1 | 74.2 | 78.5 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 15.5 | 47 | 15.5 | 10.9 | 19.1 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 23.2 | 47 | 23.8 | 15.5 | 29 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 38.8 | 48 | 38.9 | 29.2 | 52.6 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 52.9 | 48 | 52.5 | 42.9 | 63.5 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 20.3 | 46 | 33.9 | 28.6 | 43.3 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 35.4 | 46 | 54.5 | 48.3 | 64.9 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 45.1 | 45 | 42.1 | 39.2 | 45.5 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 12.5 | 45 | 12.2 | 8.1 | 14.4 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 55.2 | 43 | 56.6 | 50.1 | 64.6 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 29.7 | 43 | 29.5 | 17.5 | 37.4 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 41.8 | 43 | 41.3 | 36.9 | 44.8 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 10.2 | 43 | 11 | 7.9 | 15.1 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 44.4 | 44 | 43.4 | 41 | 47.7 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 16.0 | 44 | 15.8 | 10.5 | 18.5 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 7.7 | 32 | 6.7 | 9 | 3.2 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 56.1 | 33 | 56.2 | 51.6 | 71 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 60.9 | 45 | 57.8 | 53.8 | 63.1 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 56.7 | 45 | 58 | 53.4 | 62.9 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 60.1 | 45 | 57.9 | 53.1 | 62.4 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 52.9 | 34 | 43.3 | 40.1 | 54.4 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 24.6 | 38 | 57.7 | 52.1 | 62.1 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 0.9323 | 39 | 0.9752 | 1.1244 | 0.8998 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 19.6 | 38 | 17.2 | 21.8 | 13.6 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 39.8 | 34 | 29.8 | 40.6 | 23.2 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 32.7 | 34 | 23.9 | 33.4 | 17.1 | null | Mathematica 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 | 2,022 | Medicaid | Administrative | 2.6 | 33 | 3.1 | 4.7 | 2.2 | null | Mathematica 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 | 2,022 | Medicaid | NCI In-Person Survey | 85.1 | 27 | 90.7 | 89.1 | 94.4 | null | 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 Ju... | 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 o... | 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 | 2,022 | Medicaid | NCI In-Person Survey | 96.7 | 27 | 94.5 | 89.8 | 96.7 | null | 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 Ju... | 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 o... | 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 | 2,022 | Medicaid | Administrative | 21.6 | 39 | 23.9 | 21.2 | 25.9 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 3.9 | 39 | 4.3 | 3.5 | 5.8 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 14.8 | 39 | 11.7 | 8.7 | 13.6 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 40.1 | 39 | 38.6 | 34.1 | 41.3 | null | Mathematica analysis of the 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 | 2,022 | Medicaid | Administrative | 3.2 | 37 | 2.1 | 0.9 | 3 | null | Mathematica analysis of the 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 |
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