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Highlighting HEDIS®: Pharmacotherapy management of COPD exacerbation

January 30, 2015

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This article series is a monthly tool to help physicians maximize patient health outcomes in accordance with NCQA's* HEDIS®† measurements for high quality care on important dimensions of services.

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

HEDIS® definition

Pharmacotherapy management of COPD exacerbation: The percentage of chronic obstructive pulmonary disease (COPD) exacerbations for members ages 40 and older who had an acute inpatient discharge or emergency department visit on or between January 1 – November 30 of the measurement year and who were dispensed appropriate medications. Two rates are reported:

  1. Dispensed a bronchodilator (or there was evidence of an active prescription) within 30 days of the event;
  2. Dispensed a systemic corticosteroid (or there was evidence of an active prescription) within 14 days of the event.

Note: The eligible population for this measure is based on acute inpatient discharges and emergency department visits, not on members. It is possible for the denominator to include multiple events for the same individual.

Plan Performance

For this measure, the HEDIS 2014 rates for all Independence plans fall below the HEDIS 90th percentile benchmark, an industry indicator of excellence and desired target for each plan. Performance compared to the HEDIS 90th percentile is broken down by line of business and plan type below.


Bronchodilator dispense rateSystemic corticosteriod dispense rate
SourceCommercialMedicare
HMOPPOHMOPPO
Independence81.4%74.1%74.9%< /td>N/A
HEDIS 90th percentile88.0%89.0%
SourceCommercialMedicare
HMOPPOHMOPPO
Independence78.2%70.5%66.9%< /td>N/A
HEDIS 90th percentile81.0%78.0%
N/A = The PPO Medicare plan did not meet the minimum required sample size for reporting.


Why this measure is important

While other major causes of death have been decreasing, COPD mortality has risen, making it the fourth leading cause of death in the U.S. The disease results in both direct and indirect costs, and exacerbations of COPD account for the greatest burden on the health care system, though studies have shown that proper management of exacerbations may have the greatest potential to reduce the clinical, social, and economic impact of the disease. Pharmacotherapy is an essential component of proper management.
? NCQA, HEDIS 2015 V1


Did you know?

Independence Health Coaches can collaborate with you to support and guide patients through an acute or chronic episode to help achieve the medical treatment goals you establish. Please provide the Independence Health Coach phone number to your patients. Independence Health Coaches are available 24 hours a day, seven days a week and can support your patients as they make important decisions about their health. Ask them to call 1-800-ASK-BLUE(1-800-275-2583) and say "Health Coach" when prompted.

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

† 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.

‡HEDIS 2014 rates reflect data collected in 2013.

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

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