Mount Carmel Health Partners HEDIS Tip Sheets - Page 4

HEDIS Tip Sheet Annual Monitoring for Patients on Persistent Medications: Angiotensin Converting Enzyme (ACE) Inhibitor and Angiotensin Receptor Blockers (ARBs) Definition: Percentage of members 18 years of age and older who received at least 180 treatment days of ambulatory medication therapy for an ACE inhibitor or ARB during the measurement period and at least one therapeutic monitoring event during the measurement period. Service Needed: At least one serum potassium and serum creatinine during the measurement period. Either a lab panel test (CMP, BMP, Chem7, and Chem14) or serum creatinine and serum potassium meet the guideline. Exclusions: Hospice care in the measurement year. Chart Review Tips: • ACE inhibitors and ARBs can be found in the "Medications" section of the chart or noted in the recent office visit/progress note. • Serum creatinine and serum potassium levels can be found in the "Lab" section of the chart. Member Outreach Tips: • Ask patients if they are taking (or have been prescribed) a medication for high blood pressure (hypertension), the name of the medication, and how long they have been taking it before asking if they have had any lab tests. • If patients have not had their potassium and creatinine levels checked within the last year, ask them to schedule an appointment with their PCP to have this scheduled. More than likely, this would be at their annual preventive visit. Supplemental Data Tips • There should be little need for supplemental data for this measure because the potassium and creatinine values are not needed to meet the measure; in other words, a simple claim that the tests were done is sufficient. • The serum creatinine and serum potassium tests do not need to be on the same day, only done within the current measurement year. • A patient may switch with any medication on the ACE/ARB list during the measurement year. ACEIs Include: Lotrel (amlodipine/benazepril) Vaseretic (enalapril/HCTZ) Uniretic (moexipril/HCTZ) Lotensin (benazepril) Fosinopril Perindopril Lotensin HCT (benazepril/hydrochloro-thiazide[HCTZ]) Fosinopril/HCTZ Accupril (quinapril) Captopril Prinivil (lisinopril) Accuretic (quinapril/HCTZ) Captopril/HCTZ Zestril (lisinopril) Altace (Ramipril) Epaned (enalapril powder for oral solution) Zestorectic (Lisinopril/HCTZ) Mavik (trandolapril) Vasotec (enalapril) Univasc (moexipril) Tarka (trendolapril/verapamil) ARBs Include: Azor (amlodipine/olmesartan) Teveten (eprosartan) Benicar HCT (olmesartan/HCTZ) Exforge HCT (amlodipine/valsartan) Teveten HCT (eprosartan/HCTZ) Tribenzor (olmesartan/amlodipine/HCTZ) 4