Clinical Quality Measure Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW
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1 Clinical Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW NQF 0105 PQRS 9 NQF 0002 PQRS 66 Antidepressant Medication Management Appropriate Testing for Children with Pharyngitis (2-18 years) PQRS 65 Appropriate Treatment for Children with Upper Respiratory Infection (3mos-18 years) Asthma: NQF 0036 Use of Appropriate Medications for People with Asthma (5-11 years; years; and total) NQF 0047 PQRS 53 Asthma Pharmacologic Therapy (percentage of patients 5-40 years with a diagnosis of mild, moderate, or severe persistent asthma who were prescribed medication) Medication Management For People With Asthma (5-11 years; years; and total) (2-18 years) (3mos-18 years) (3 mos-18 years) NQF 001 PQRS 64 PQRS 116 NQF 0031 PQRS 112 PQRS 47 Asthma Assessment (5-40 years) (5-50 years) Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (18-64 years of age) Breast Cancer Screening (Women 40-69) (Women 40-69) Care for Older Adults: a) Advanced Care Planning, b) Medication Review, c) Functional Status Assessment, d) Pain Screening NQF 0032 Cervical Cancer Screening (Women 21-64) NQF 0033 Chlamydia Screening (Women 42-69) (Women 24-64) Page 1
2 Clinical Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW NQF 0075 NQF 0034 PQRS 113 (Women 16-24) (Women 15-24) Cholesterol Management for Patients with Cardiovascular Conditions (Control LDL-C Level <100 mg/dl) Cholesterol Management for Patients with Cardiovascular Conditions (LDL-C Screening) Colorectal Cancer Screening* (50-75 years) (50-75 years) COPD: PQRS 52 Pharmacotherapy Management of COPD Exacerbation- Bronchodilator Pharmacotherapy Management of COPD Exacerbation-Systemic Corticosteroid PQRS 51 Use of Spirometry Testing in the Assessment and Diagnosis of COPD NQF 0070 PQRS 7 NQF 0074 PQRS 197 NQF 0067 PQRS 6 Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) Drug Therapy for Lowering LDL-Cholesterol (42 years and LDL Testing (Screening) Oral Antiplatelet Therapy Prescribed for Patients with CAD Page 2
3 Clinical Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW Diabetes: NQF 0061 PQRS 3 NQF 0064 PQRS 2 NQF 0055 PQRS 117 NQF 0088 PQRS 18 NQF 0089 PQRS 19 Comprehensive Diabetes Care- Blood Pressure Control (<130/80 mm Hg) Comprehensive Diabetes Care- Blood Pressure Control (<140/90 mm Hg) Low Density Lipoprotein (LDL) Management and Control- LDL- C < 100 mg/dl LDL-C Screening Eye Exams Diabetic Retinopathy: Presence or Absence of Macular Edema and Level of Severity Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care NQF 0062 PQRS 119 Diabetes Urine Screening NQF 0056 PQRS 163 Foot Exam PQRS 229 HbA1c Testing HbA1c Control (<7% for a selected population) NQF 0575 HbA1c Control (<8%) (Testing) Page 3
4 Clinical Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW NQF 0059 PQRS 1 Poor HbA1c Control (>9.0%) PQRS 108 Medical Attention for Nephropathy (screening) Disease Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis PQRS 154 Fall Risk Management*** NQF 0041 PQRS 110 NQF 0086 PQRS 12 Flu Shots for Adults* (50-64 years) (Patients 50 years old) Flu Shots for Older Adults*** FU After Hospitalization For Mental Illness- a) 30 days, b) 7 days FU Care for Children Prescribed ADHD Medication- a) Initiation, b)continuation & Maintenance Glaucoma: Screening in Older Adults Primary Open Angle Glaucoma: Optic Nerve Evaluation (Patients 50 years old) (Patients 50 years old) Page 4
5 Clinical Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW Heart Failure: NQF 0081 PQRS 5 NQF 0083 PQRS 8 NQF 0084 PQRS 200 NQF 0018 PQRS 236 Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin- Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) Warfarin Therapy Patients with Atrial Fibrillation Persistence of Beta-Blocker Treatment after a Heart Attack Hypertension: Controlling High Blood Pressure (with diagnosis of HTN) (18-85 years) NQF 0013 PQRS 237 NQF 0038 PQRS 240 Blood Pressure ment Immunizations: Childhood Immunization Status: (By 2 years of age) o Combo 2 (Combination of 4 DTaP, 3 IPV, 1 MMR, 2 o HiB, 3 Hep B, and 1 VZV) Combo 3 (Combo 2 with 4 pneumococcal conjugate) o 4 DtaP o 3 Hepatitis B (Requires Page 5
6 Clinical Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW NQF 0004 NQF 0073 PQRS 201 NQF 0068 PQRS 204 NQF 0075 PQRS 202 and 203 o 2 HiB 3 (HiB) o 3 IPV o 1 MMR o 4 Pneumococcal Conjugate o 1 VZV o 2 Hepatitis A o 2-3 Rotavirus o 2 Influenza For Adolescents (age 13) Human Papillomavirus Vaccine For Female Adolescents Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: (a) Initiation, (b) Engagement Ischemic Vascular Disease (IVD): Blood Pressure Management (Controlled < 140/90) Use of Aspirin or Another Antithrombotic Complete Lipid Panel and LDL Control Lead Screening in Children** PQRS 50 Management of Urinary Incontinence in Older Adults*** Medication: Annual Monitoring for Patients on Persistent Medications: a) ACE or ARB, b) Anticonvulsants, c) Digoxin, d) Diuretics, e) Total Page 6
7 Clinical Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW Aspirin Use and Discussion PQRS 46 Medication Reconciliation Post-Discharge *** Potentially Harmful Drug-Disease Interaction in the Elderly*** Use of High-Risk Medications in the Elderly*** Oncology: NQF 0387 PQRS 71 NQF 0385 PQRS 72 Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer Colon Cancer: Chemotherapy for Stage III Colon Cancer NQF 0389 Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging PQRS 102 Low Risk Prostate Cancer Patients Osteoporosis: *** PQRS 40 Management in Women who had a Fracture (50 years and PQRS 39 Testing in Older Women (Screening 65 years and NQF 0043 PQRS 111 Physical Activity in Older Adults*** Pneumonia Vaccination Status for Older Adults*** Prenatal Care: (Patients 65 years old) Page 7
8 Clinical Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW NQF 0012 Screening for Human Immunodeficiency Virus (HIV) NQF 0014 Anti-D Immune A Globulin Tobacco Use: NQF 0027 PQRS 115 NQF 0028 PQRS 226 Smoking and Tobacco Use Cessation, Medical Assistance: a). Advising Smokers and Tobacco Users to Quit, b). Discussing Smoking and Tobacco Use Cessation Medications, c). Discussing Smoking and Tobacco Use Cessation Strategies Preventative Care and Screening Pair: a). Tobacco Use Assessment, b). Tobacco Cessation Intervention ` NQF 0052 Use of Imaging Studies for Low Back Pain Weight and BMI: Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents- Counseling for Nutrition (3-11 years; NQF 0024 PQRS 239 NQF 0421 PQRS 128 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents - BMI percentile Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents - Counseling for Physical Activity years; Total) (3-11 years; years; Total) (3-11 years; years; Total) Adult BMI Assessment Adult Weight Screening and Follow-up: 18 years and older with a calculated BMI in past 6 months (2-17 years) Page 8
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