2015 HEDIS REFERENCE SHEET Annual Monitoring for Patients on Persistent Medications Which members are included in the sample? The percentage of members 18 years of age and older who received at least 180 treatment days of ambulatory medication therapy for a select therapeutic agent during the measurement year and at least one therapeutic monitoring event for the therapeutic agent in the measurement year. For each product line, report each of the three rates separately and as a total rate. • Annual monitoring for members on angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB). • Annual monitoring for members on digoxin. • Annual monitoring for members on diuretics. • Total rate (the sum of the three numerators divided by the sum of the three denominators). Rate 1: Annual Monitoring for Members on ACE or ARBs At least one serum potassium and a serum creatinine therapeutic monitoring test in the measurement year. Any of the following during the measurement year meet criteria: • A lab panel test (Lab Panel Value Set). • A serum potassium test (Serum Potassium Value Set) and a serum creatinine test (Serum Creatinine Value Set). Note: The tests do not need to occur on the same service date, only within the measurement year. Rate 2: Annual Monitoring for Members on Digoxin Members who received at least 180 treatment days of digoxin during the measurement year. • At least one serum potassium, at least one serum creatinine, and at least one serum digoxin therapeutic monitoring test in the measurement year. Any of the following meet criteria: • A lab panel test (Lab Panel Value set) and a serum digoxin test (Digoxin Level Value Set). • A serum potassium test (Serum Potassium Value Set) and a serum creatinine test (Serum Creatinine Value Set) and serum digoxin test (Digoxin Level Value Set). Note: The HEDIS 2015 Criteria for the Annual Monitoring for Patients on Persistent Medications measure is derived from the NCQA HEDIS 2015 Technical Specifications, Volume 2. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). Rate 3: Annual Monitoring for Members on Diuretics Members who received at least 180 treatment days of a diuretic during the measurement year. Note: Members may switch therapy with any medication listed in Table MPM-C during the measurement year and have the days supply for those medications count toward the total 180 treatment days. At least one serum potassium and a serum creatinine therapeutic monitoring test in the measurement year. Any of the following meet criteria: • A lab panel test (Lab Panel Value Set). • A serum potassium test (Serum Potassium Value Set) and a serum creatinine test (Serum Creatinine Value Set). Note: The tests do not need to occur on the same service date, only within the measurement year. Drugs to Identify Members on Diuretics Description Antihypertensive combinations Loop diuretics Potassium-sparing diuretics Thiazide diuretics • • • • • • • • • • • • • • • • • • • • • Prescription Aliskiren-hydrochlorothiazide • Fosinopril-hydrochlorothiazide Aliskiren-hydrochlorothiazide-amlodipine • Hydrochlorothiazide-irbesartan Amiloride-hydrochlorothiazide • Hydrochlorothiazide-lisinopril Amlodipine-hydrochlorothiazide-olmesartan • Hydrochlorothiazide-losartan Amlodipine-hydrochlorothiazide-valsartan • Hydrochlorothiazide-methyldopa Atenolol-chlorthalidone • Hydrochlorothiazide-metoprolol Azilsartan-chlorthalidone • Hydrochlorothiazide-moexipril Benazepril-hydrochlorothiazide • Hydrochlorothiazide-olmesartan Bendroflumethiazide-nadolol • Hydrochlorothiazide-propranolol Bisoprolol-hydrochlorothiazide • Hydrochlorothiazide-quinapril Candesartan-hydrochlorothiazide • Hydrochlorothiazide-spironolactone Captopril-hydrochlorothiazide • Hydrochlorothiazide-telmisartan Chlorthalidone-clonidine • Hydrochlorothiazide-triamterene Enalapril-hydrochlorothiazide • Hydrochlorothiazide-valsartan Eprosartan-hydrochlorothiazide Bumetanide • Furosemide Ethacrynic acid • Torsemide Amiloride • Spironolactone Eplerenone • Triamterene Chlorothiazide • Hydrochlorothiazide • Methyclothiazide Chlorthalidone • Indapamide • Metolazone Note: The HEDIS 2015 Criteria for the Annual Monitoring for Patients on Persistent Medications measure is derived from the NCQA HEDIS 2015 Technical Specifications, Volume 2. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). Note: NCQA will post a comprehensive list of medications and NDC codes to www.ncqa.org by November 3, 2014. Product Lines: Commercial, Medicaid and Medicare. Exclusions: Members from each eligible population rate who had an inpatient (acute or non-acute ) claim/encounter during the measurement year. Documentation Required This measure is based on claims and encounter data. Continuous enrollment The measurement year. Can administrative data be used to satisfy this measure? Yes. This measure is reviewed using administrative data. How can we improve the score of this HEDIS measure?    Use correct diagnosis and procedure codes. Submit claims and encounter data in a timely manner. Educate patients on the effects and side effects of their medications to improve compliance. Note: The HEDIS 2015 Criteria for the Annual Monitoring for Patients on Persistent Medications measure is derived from the NCQA HEDIS 2015 Technical Specifications, Volume 2. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).