NEW 2016 BCBS AQC Measures
Two new measures have been added to the BCBS AQC Quality Measure requirement for 2016. Baseline data collected in 2015 suggests a need for review and education. The new measures are:
1. Asthma Medication Ratio (AMR)-
Percentage of members 5-85 years of age who were identified as having persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater during the Quality Measurement Period.
WHY: To identify persistent asthmatics who are non-adherent with controller medications and/or those patients who may benefit from a long-term control medication (including patients w/Exercise Induced Bronchospasm)
WHO: Patients age 5-85 with persistent asthma, having at least 1 of the following criteria during both 2015 and 2016:
- 1 or more ED visits or acute IP encounters with principal dx asthma
- 4 or more outpatient visits or observation visits with any diagnosis of asthma + 2 or more asthma medication dispensing events
- 4 or more asthma medication dispensing events
See the
Asthma Medication Ratio (AMR)
detail sheet for additional information on how the AMR is calculated. Asthma medication guidelines with relative costs for controllers and other asthma medications is also included.
2. Use of imaging studies in Low Back Pain-
The percentage of patients with acute low back pain who did not have an imaging study, (plain x-ray, CT scan or MRI) within 28 days of the diagnosis of low back pain.
WHY: Low back pain is pervasive. Most common reason for visits to offices, outpatient departments and Emergency Rooms.
- Imaging potentially can lead to unnecessary surgery and usually adds nothing to the course.
- Most patients are back to their usual activities within 30 days and their course is unaffected by imaging. Pain usually improves within the first two weeks.
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