Mount Carmel Health Partners HEDIS Tip Sheets - Page 19

HEDIS Tip Sheet Medication Adherence for Cholesterol Definition: Percentage of Part D beneficiaries, ages 18 and older, who fill their cholesterol medication (statin drug) enough to cover 80% or more of the time they are taking the medication. Service Needed: Filling prescriptions for cholesterol medications. Exclusions: Hospice care in the measurement year. Chart Review Tips: • Cholesterol medications include statins. • Cholesterol medications can be found in the “Medications” section of the chart or noted in the recent office visit/progress note. Member Outreach Tips: • Ask patients if they are taking (or have been prescribed) a medication for cholesterol. • Encourage patients to take medications as prescribed. If patients do not take medication as prescribed, ask why: Lack of funds? A problem with side effects? Supplemental Data Tips • This measure must be met through either pharmacy data or claims, meaning supplemental data cannot be used. • Patients may be taking medication as prescribed and not using their insurance benefits (for example: $4 prescriptions), which would cause them to appear not meet the metric falsely. Statin medications include: • Advicor (niacin extended-release/lovastatin) • Altoprev (lovastatin extended-release) • Caduet (amlodipine and atorvastatin) • Crestor (rosuvastatin) • Juvisync (sitagliptin/simvastatin) • Lescol (fluvastatin) • Lescol XL (fluvastatin extended-release) • Lipitor (atorvastatin) • Liptruzet (atorvastatin-ezetimibe) • Lipitor (atorvastatin) • Livalo (pitavastatin) • Mevacor (lovastatin) • Pravachol (pravastatin) • Simcor (niacin extended-release/simvastatin) • Vytorin (ezetimibe/simvastatin) • Zocor (simvastatin) 19