- National Quality Forum NQF 0545 Measurement Year 2011 to 2013
- Adherence to Statins for Individuals with Diabetes Mellitus
- Drugs for Diabetes Mellitus
- Diabetes Mellitus
- Adherence to Statins
- Quality Healthcare
- NQF Measures
- Medication Measures
- Healthcare Processes
- CMS Special Innovation Project
- Diabetes Data
- Medication Measures
Adherence to Statins for Individuals with Diabetes Mellitus NQF 0545
This dataset contains the information on the measure “Adherence to Statins for Individuals with Diabetes Mellitus NQF (National Quality Forum) 0545” or “NQF-0545” which addresses adherence to three types of chronic medications; statins, angiotensin converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and oral hypoglycemic agents.
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The measure is divided into three submeasures:
Measure A: The percentage of eligible individuals who had at least two prescriptions for statins and who have a Proportion of Days Covered (PDC) of at least 0.8 during the measurement period (12 consecutive months).
Measure B: The percentage of eligible individuals who had at least two prescriptions for ACEIs/ARBs and who have a PDC of at least 0.8 during the measurement period (12 consecutive months).
Measure C: The percentage of eligible individuals who had at least two prescriptions for a single oral hypoglycemic agent or at least two prescriptions for multiple agents within an antidiabetic class and who have a PDC of at least 0.8 for at least 1 antidiabetic class during the measurement period (12 consecutive months).
CMS (Centers for Medicare & Medicaid Services) has contracted with FMQAI (Florida’s Medicare Quality Improvement Organization) to provide services for the Medication Measures Special Innovation Project, the purpose of which is to develop measures that can be used to support quality healthcare delivery to Medicare beneficiaries. The project currently has a portfolio of eight NQF-Endorsed measures for the ambulatory care setting, NQF 0543, NQF 0545, NQF 0555, NQF 0556, NQF 1879, NQF 1880, NQF 2362, NQF 2363, NQF 2379, NQF 2467, NQF 2468.
Quality health care is a high priority for the President, the Department of Health and Human Services (HHS), and the Centers for Medicare & Medicaid Services (CMS). CMS implements quality initiatives to assure quality health care for Medicare Beneficiaries through accountability and public disclosure. CMS uses quality measures in its various quality initiatives that include quality improvement, pay for reporting, and public reporting.
Quality measures are tools that help to measure or quantify healthcare processes, outcomes, patient perceptions, and organizational structure and/or systems that are associated with the ability to provide high-quality health care and/or that relate to one or more quality goals for health care. These goals include effective, safe, efficient, patient-centered, equitable and timely care.
CMS has contracted with FMQAI (Florida’s Medicare Quality Improvement Organization) to provide services for the Medication Measures Special Innovation Project, the purpose of which is to develop measures that can be used to support quality healthcare delivery to Medicare beneficiaries.
The key objectives of the project are to:
– Develop new and maintain previously developed medication measures with the potential for National Quality Forum (NQF) endorsement.
– Adapt/specify existing NQF-endorsed medication measures and develop new measures for implementation in CMS reporting programs, such as
– Hospital Inpatient Quality Reporting (IQR) Program
– Hospital Outpatient Quality Reporting (OQR) Program
– Physician Quality Reporting System (PQRS)
– Others as directed by CMS, such as long-term care settings and ambulatory care settings.
– Continue to develop new medication measures that address the detection and prevention of adverse medication-related patient safety events that can be used in future Quality Improvement Organization (QIO) Statements of Work and in CMS provider reporting programs; and
– Identify and specify up to five new adverse event measures (non-medication-related) that could be used in future QIO programs and CMS provider reporting programs in the hospital setting (inpatient and/or emergency department).
In addition to maintenance of previously developed medication measures, the new measures to be developed under this special project support QIO patient safety initiatives by addressing topics, such as the detection and prevention of medication errors, adverse drug reactions, and other patient safety events. Under this Special Innovation Project, existing measures, as well as new measures, are being refined and specified for implementation in provider reporting programs.
The project currently has a portfolio of eight NQF-endorsed measures for the ambulatory care setting, five of which (i.e., NQF 0545, NQF 0555, NQF 0556, NQF 2467, NQF 2468) are undergoing NQF comprehensive review and have received recommendations for re-endorsement. In addition, one measure (i.e., NQF 2379) for the ambulatory care setting and two electronic clinical quality measures (i.e., NQF 2362 and NQF 2363) for the inpatient care setting have been submitted to NQF and have received recommendations for endorsement.
– NQF 0543: Adherence to Statin Therapy for Individuals with Coronary Artery Disease
– NQF 0545: Adherence to Statins for Individuals with Diabetes Mellitus
– NQF 0555: INR Monitoring for Individuals on Warfarin
– NQF 0556: INR for Individuals Taking Warfarin and Interacting Anti-infective Medications
– NQF 1879: Adherence to Antipsychotic Medications for Individuals with Schizophrenia
– NQF 1880: Adherence to Mood Stabilizers for Individuals with Bipolar I Disorder
– NQF 2362: Glycemic Control – Hyperglycemia
– NQF 2363: Glycemic Control – Severe Hypoglycemia
– NQF 2379: Adherence to Antiplatelet Therapy after Stent Implantation
– NQF 2467: Adherence to ACEIs/ARBs for Individuals with Diabetes Mellitus
– NQF 2468: Adherence to Oral Diabetes Agents for Individuals with Diabetes Mellitus
The maintenance of these measures requires the specifications to be updated annually.
– Measure Updates – Adherence to Statins for Individuals with Diabetes Mellitus NQF 0545:
– 2011 Updates
– See Excel Attachment of Code Tables for NDC updates.
– Updated National Drug Codes (NDCs) as of October 28, 2011.
– Added new combination drug sitagliptin-simvastatin.
– Added new diabetic drug linagliptin
– Updated ICD-9-CM and ICD-10-CM diagnosis codes used to identify diabetes mellitus with recent changes, added 648.00, 648.01, 648.02, 648.03, 648.04, and removed invalid code 648.0.
– Updated visit type codes with recent changes, added 99224-99226. 414.07, 414.4
– 2012 Updates
– Updated National Drug Codes (NDCs) as of October 31, 2012.
– See Codes Table attachment for NDC Updates and ICD-9-CM to ICD-10-CM Crosswalk.
– Added azilsartan to “Angiotensin II Inhibitors.”
– Added amlodipine-olmesartan-hydrochlorothiazide to Antihypertensive Combinations.
– Added azilsartan medoxomil-chlorthalidone to Antihypertensive Combinations.
– Added linagliptin-metformin to Anti-diabetic Combinations.
– Deleted insulin isophane (pork), insulin regular (pork), insulin zinc (human), insulin zinc (pork), and insulin zinc extended (human) from Insulin.
– Modified age requirement to at least 18 at the beginning of the measurement period.
– 2013 Updates
– ICD-9-CM, ICD-10-CM, and National Drug Codes have been updated annually.
– Optional criteria to stratify the measure between new and continuous users were removed to harmonize with other NQF-endorsed measures.
– The new drugs on the market that are applicable to the measure have been added to the medication list, and agents that have been discontinued for more than three years have been removed.
About this Dataset
John Snow Labs; Centers for Medicare and Medicaid Services (CMS), Florida's Medicare Quality Improvement Organization (FMQAI);
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Drugs for Diabetes Mellitus, Diabetes Mellitus, Adherence to Statins, Quality Healthcare, NQF Measures, Medication Measures, Healthcare Processes, CMS Special Innovation Project, Diabetes Data, Medication Measures
National Quality Forum NQF 0545 Measurement Year 2011 to 2013, Adherence to Statins for Individuals with Diabetes Mellitus
|Measurement_Category||Quality Performance Measurement category||string||required : 1|
|Measurement_Year||Quality Performance Measurement Year||date||required : 1|
|National_Drug_Code||National Drug Code assigned to each drug||string||required : 1|
|Generic_Name||Drug's generic name/non-proprietary name||string||required : 1|
|Strength_of_Drug||Strength of dosage form||string||required : 1|
|Brand_Name||Drug's brand name/proprietary name/trade name||string||required : 1|
|Inactive_Date||Drug inactive date||date||-|
|Route_of_Administration||Route through which the drug is administered||string||required : 1|
|Dosage_Form||Dosage form in which the drug is supplied||string||required : 1|
|Drug_Pharmacological_Group||Pharmacological class of drug||string||required : 1|