ADH
Part D · Triple-weighted
Medication Adherence
Diabetes, cholesterol, and hypertension medications — the 80% Proportion of Days Covered (PDC) rule, member by member.
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FMC
Part C · Care coordination
Follow-up after ED Visit
Timely follow-up for members with multiple high-risk chronic conditions after an emergency department visit.
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COA
Part C · SNP · Process
Care for Older Adults
Medication Review (COA-M) and Functional Status Assessment (COA-F) for SNP members 66 and older.
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MTM
Part D · CMR completion
MTM Program Completion Rate for CMR
Comprehensive Medication Reviews for eligible members, and the completion rate CMS scores each contract on.
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POLY
Medication safety
Poly-ACH & COB
Identifying members on high-risk medication combinations and coordinating benefits across payers.
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SUPD
Part D · Statins
Statin Use in Persons with Diabetes
The Part D measure for statin therapy in members with diabetes — how it's calculated, and where members fall out.
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