Denominator: Patients 65 years and older who had a visit during the performance period.
- Exclusion: patients who were in Hospice care during the measurement year
Numerator 1: Patients with an order for at least one high-risk medication during the performance period OR an order for at least one high-risk medication with days supply criteria with a cumulative medication duration > 90 days during the performance period.
Numerator 2: Patients with at least two orders for the same high-risk medication during the performance period OR at least two orders for the same high-risk medication with days supply criteria with a cumulative medication duration > 90 days during the performance period.
A lower score indicates better quality
- Measure pertains to medications prescribed by the doctor being measured, not those medications prescribed by others
- “Visit” is an encounter with at least one service with CPT code: 92002, 92012, 92004, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99337, 99385, 99386, 99387, 99395, 99396, 99397, 92002, 92004, 92012, 92014, G0438, G0439
- “Cumulative medication duration” is an individual's total number of medication days over a specific period; the period counts multiple prescriptions with gaps in between, but does not count the gaps during which a medication was not dispensed.
- Example: a patient has an original prescription for 30 days with 2 refills for thirty days each. After a gap of 3 months, the medication was prescribed again for 60 days with 1 refill for 60 days. The cumulative medication duration is (30 x 3) + (60 x 2) = 210 days over the 10 month period.
- “Patients who were in Hospice care during the measurement year” is a patient with a SNOMED code of 385763009 – Hospice care (regime/therapy) or 385765002 – Hospice care management (procedure)
“High-risk medications” are listed in Appendix B
“High-risk medications with days supply criteria” are listed in Appendix C