This article series is a monthly tool to help physicians maximize patient health outcomes in accordance with NCQA?s¹ HEDIS^®2 measurements for high quality care on important dimensions of services.

Go to our Highlighting HEDIS^® web page to view previously published topics. If you have feedback or would like to request a topic, email us.

HEDIS^® definition

Persistence of beta-blocker treatment after a heart attack: The percentage of members ages 18 and older during the measurement year who were hospitalized and discharged alive from July 1 of the year prior to the measurement year to June 30 of the measurement year with a diagnosis of an acute myocardial infarction (AMI) and who received persistent beta-blocker treatment for six months after discharge.

Note: Members identified as having an allergy or intolerance to beta-blocker therapy in their medical history may be excluded. Any of the following conditions meet the exclusion criteria: asthma, COPD, obstructive chronic bronchitis, chronic respiratory conditions due to fumes and vapors, hypotension, heart block >1 degree, sinus bradycardia, or a medication dispensing event indicative of a history of asthma.

Importance of beta-blocker therapy

According to results of large-scale clinical trials, beta-blockers consistently reduce subsequent coronary events, cardiovascular mortality, and all-cause mortality by 20 – 30 percent after an AMI when taken indefinitely. Literature suggests that adherence to beta-blockers declines significantly within the first year. About half of AMI survivors who are eligible for beta-blocker therapy do not receive it. Test data reveal significant underutilization of beta-blockers 180 days post-AMI. There is evidence suggesting that around 2,900 – 5,000 lives are lost in the United States in the first year following an AMI, from the under-prescribing of beta-blockers. ? NCQA, HEDIS 2013 V1

Plan performance

Beta-blocker compliance rates reached the 50th percentile for commercial HMO members, but did not reach the 50th percentile for commercial PPO members. There is room for improvement for both groups to reach higher benchmarks and enhanced standards of care.

Did you know?

AmeriHealth New Jersey case managers can collaborate with you to support and guide your patients through an acute or chronic episode to help achieve the medical treatment goals you establish. AmeriHealth New Jersey case managers can support your patients as they make important decisions about their health. Ask your AmeriHealth New Jersey patients to call 1-888-YOUR-AH1 (1-888-968-7241) and say ?Case Management? when prompted.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Used with permission.

¹ The National Committee for Quality Assurance (NCQA) is the most widely recognized accreditation program in the U.S.

² The Healthcare Effectiveness Data and Information Set (HEDIS) is an NCQA tool used by more than 90 percent of U.S. health plans to measure performance on important dimensions of care.