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Dear TCCN Providers and Practice Administrators,
Congratulations and thank you! We have demonstrated significant improvement with our Anthem contracted measure of Appropriate Testing for Children with Pharyngitis. Earlier in the year, we sent our practice scorecards and requested practices to review the scorecard and look for areas of improvement within their office. Thank you for all your hard work on this measure!
Measure Definition: Identifies children 3–18 years of age who were diagnosed with pharyngitis, dispensed an antibiotic, and had a test for group A streptococcus for the episode. A higher rate represents better performance (i.e., appropriate testing).
Pharyngitis is a double-targeted measure for both performance and quality improvement. Pharyngitis is a leading cause of pediatric ambulatory care visits. It can be caused by bacterial strep infections, which are treated with antibiotics, or by viral infections. Proper testing for strep and treatment of pharyngitis can help prevent the spread of sickness. Testing also can reduce the unnecessary use of antibiotics for viral pharyngitis (BCBS).
Our staff has been working with Anthem over the course of the year. Through our investigation we were able to demonstrate to Anthem that 84% of non-compliant patients, although attributed to a TCCN provider, were not in fact seen by a TCCN provider. Not only did this show that our network providers have been doing a great job with this measure, but it also provided us with valuable perspective on ways that your practices might better communicate with parents and leverage your services to reduce urgent/emergency services and thereby the inappropriate use of antibiotics and spread of sickness.
Thanks to your hard work and continued support, TCCN is performing well above Anthem’s monthly average and continues to close the gap between our network’s performance and Anthem’s top performers for this measure (see run chart below). This improvement is just another demonstration of the quality of care you provide to your patients.
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