Msr. Type |
Code | CMS Id | Weight | Measure | Avg. Score | Avg. Star |
---|---|---|---|---|---|---|
DM | EDFUH | DMC01 | 0 | Follow-up Visit after Hospital Stay for Mental Illness (within 30 days of discharge) | 46 | 0 |
DM | EDAMM | DMC02 | 0 | Antidepressant Medication Management (6 months) | 66 | 0 |
DM | EDCBBT | DMC03 | 0 | Continuous Beta Blocker Treatment | 88 | 0 |
DM | EDTCCOPD | DMC04 | 0 | Testing to Confirm Chronic Obstructive Pulmonary Disease | 27 | 0 |
DM | AHDCW | DMC05 | 0 | Doctors who Communicate Well | 92 | 0 |
DM | MSC-CBHT | DMC06 | 0 | Call Center - Beneficiary Hold Time | 0.36 | 0 |
DM | AHPNU | DMC07 | 0 | Pneumonia Vaccine | 69 | 0 |
DM | EDAPCDV | DMC08 | 0 | Access to Primary Care Doctor Visits | 95 | 0 |
DM | MSC-CCHP | DMC09 | 0 | Call Center - Calls Disconnected When Customer Calls Health Plan | 1.84 | 0 |
DM | EDPMSC | DMC10 | 0 | Pharmacotherapy Management of COPD Exacerbation - Systemic Corticosteroid | 73 | 0 |
DM | EDPMB | DMC11 | 0 | Pharmacotherapy Management of COPD Exacerbation - Bronchodilator | 83 | 0 |
DM | EDIADT | DMC12 | 0 | Initiation of Substance Use Disorder Treatment | 34 | 0 |
DM | EDEADT | DMC13 | 0 | Engagement of Substance Use Disorder Treatment | 5 | 0 |
DM | EDHPPC | DMC14 | 0 | Hospitalization for Potentially Preventable Complications | 17 | 0 |
DM | EDFEDVP | DMC15 | 0 | Follow-up after Emergency Department Visit for Patients with Multiple Chronic Conditions | 57 | 0 |
DM | EDTRCMRP | DMC16 | 0 | Transitions of Care - Medication Reconciliation Post-Discharge | 65 | 0 |
DM | EDTRCNIA | DMC17 | 0 | Transitions of Care - Notification of Inpatient Admission | 24 | 0 |
DM | EDTRCAID | DMC18 | 0 | Transitions of Care - Patient Engagement After Inpatient Discharge | 82 | 0 |
DM | EDTRCRDI | DMC19 | 0 | Transitions of Care - Receipt of Discharge Information | 18 | 0 |
DM | EDTRCA | DMC20 | 0 | Transitions of Care - Average | 46 | 0 |
DM | EDPCR18 | DMC21 | 0 | Plan All-Cause Readmissions (18+) | 12 | 0 |
DM | EDPCR64 | DMC22 | 0 | Plan All-Cause Readmissions (18-64) | 12 | 0 |
DM | EDPCR65 | DMC23 | 0 | Plan All-Cause Readmissions (65+) | 12 | 0 |
DM | OSPFADL | DMC24 | 0 | Physical Functioning Activities of Daily Living | 94 | 0 |
DM | EDCOAFS | DMC25 | 0 | Care for Older Adults - Functional Status | 78 | 0 |
DM | EDKHEPD | DMC26 | 0 | Kidney Health Evaluation for Patients With Diabetes | 43 | 0 |
DM | OSPHL | DMC27 | 0 | Improving or Maintaining Physical Health2 | 67 | 0 |
DM | OSMHL | DMC28 | 0 | Improving or Maintaining Mental Health2 | 81 | 0 |
DM | EDCRA | DMC29 | 0 | Cardiac Rehabilitation - Achievement | 3 | 0 |
DM | EDCRE1 | DMC30 | 0 | Cardiac Rehabilitation - Engagement 1 | 7 | 0 |
DM | EDCRE2 | DMC31 | 0 | Cardiac Rehabilitation - Engagement 2 | 6 | 0 |
DM | EDCRI | DMC32 | 0 | Cardiac Rehabilitation - Initiation | 5 | 0 |
DM | MSCDCCHP | DMD01 | 0 | Call Center - Calls Disconnected When Customer Calls Drug Plan | 1.84 | 0 |
DM | MSD-CBHT | DMD02 | 0 | Call Center - Beneficiary Hold Time | 0.35 | 0 |
DM | MSMPFS | DMD03 | 0 | MPF - Stability | 100 | 0 |
DM | MSD-HOLD | DMD04 | 0 | Call Center - Pharmacy Hold Time | 0.26 | 0 |
DM | MSPSHPD | DMD05 | 0 | Plan Submitted Higher Prices for Display on MPF | 73 | 0 |
DM | AHRFP | DMD06 | 0 | Reminders to Fill Prescriptions | 54 | 0 |
DM | AHRTM | DMD07 | 0 | Reminders to Take Medications | 32 | 0 |
DM | QAAPD | DMD08 | 0 | Antipsychotic Use in Persons with Dementia (APD) | 8 | 0 |
DM | QAAPDLTN | DMD09 | 0 | Antipsychotic Use in Persons with Dementia - for Long-Term Nursing Home Residents (APD- LTNH) | - | 0 |
DM | QACOB | DMD10 | 0 | Concurrent Use of Opioids and Benzodiazepines (COB) | 8 | 0 |
DM | QAOHD | DMD11 | 0 | Use of Opioids at High Dosage in Persons Without Cancer (OHD) | 15.31 | 0 |
DM | QAOMP | DMD12 | 0 | Use of Opioids from Multiple Providers in Persons Without Cancer (OMP) | 6.6 | 0 |
DM | QAPMAMOA | DMD13 | 0 | Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) | 0.44 | 0 |
DM | QAMAMOA | DMD14 | 0 | Polypharmacy: Use of Multiple CNS-Active Medications in Older Adults (Poly-CNS) | 8.93 | 0 |
DM | QAIOP | DMD15 | 0 | Initial Opioid Prescribing (IOP-LD) | 14.06 | 0 |
DM | STINS | DMD16 | 0 | Persistence to Basal Insulin (PST-INS) | 17.38 | 0 |
DM | RGR | DME01 | 0 | Grievance Rate | 6.55 | 0 |
DM | RPGP | DME02 | 0 | Disenrollment Reasons - Problems Getting the Plan to Provide and Pay for Needed Care (MA-PD MA-only) | - | 0 |
DM | RPCD | DME03 | 0 | Disenrollment Reasons - Problems with Coverage of Doctors and Hospitals (MA-PD MA-only) | 18 | 0 |
DM | RFRD | DME04 | 0 | Disenrollment Reasons - Financial Reasons for Disenrollment (MA-PD MA-only PDP) | 23 | 0 |
DM | RPDBC | DME05 | 0 | Disenrollment Reasons - Problems with Prescription Drug Benefits and Coverage (MA-PD PDP) | 22 | 0 |
DM | RPGIHP | DME06 | 0 | Disenrollment Reasons - Problems Getting Information and Help from the Plan (MA-PD PDP) | 10 | 0 |
DM | MSD-BAPP | DME07 | 0 | Beneficiary Access and Performance Problems | 13 | 0 |
Name | URL |
---|---|
Part C & D performance data ® | https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrugcovgenin/performancedata.html |
HEDIS ® | http://www.ncqa.org/hedis-quality-measurement/hedis-measures |
2019 Final Rule | https://www.federalregister.gov/d/2019-06822/p-964 |
CY 2022 MA Announcement | https://www.cms.gov/files/document/2022-announcement.pdf |
2024 MA Final Rule | https://www.federalregister.gov/d/2023-07115/p-1427 |
2022 Final Rule | https://www.federalregister.gov/d/2021-00538/p-690 |
2025 MA Final rule | https://www.federalregister.gov/documents/2024/04/23/2024-07105/medicare-program-changes-to-the-medicare-advantage-and-the-medicare-prescription-drug-benefit |