Pharmacotherapy Management of COPD Exacerbation (PCE)
Based on current NCQA HEDIS recommendations, your TO-DO LIST for members 40 years of age or older should include:
- A dispensed prescription for systemic corticosteroid on or 14 days after the Episode Date.
Or - A dispensed prescription for a bronchodilator on or 30 days after the Episode Date.
Why should you complete your TO-DO LIST?
It is an evidence-based, best practice and these actions are used to measure your quality performance.
HEDIS Pharmacotherapy Management of COPD Exacerbation (PCE) Definition:
(NCQA HEDIS guidelines, Measurement Year (MY) 2022)
- The percentage of COPD exacerbations for members 40 years of age and older who had an acute inpatient discharge or ED visit on or between January 1 - November 30 of the measurement year and who were dispensed appropriate medications. Two rates are reported:
- Dispensed a systemic corticosteroid (or there was evidence of an active prescription) within 14 days of the event.
- Dispensed a bronchodilator (or there was evidence of an active prescription) within 30 days of the event.
- Line of Business: Commercial, Medicaid, Medicare
Requirement:
Systemic corticosteroid: Dispensed prescription for systemic corticosteroid (Systemic Corticosteroid Medications List) on or 14 days after the Episode Date. Count systemic corticosteroids that are active on the relevant date.
Bronchodilator: Dispensed prescription for a bronchodilator (Bronchodilator Medications List) on or 30 days after the Episode Date. Count bronchodilators that are active on the relevant date.
Systemic Corticosteroid Medications
Description: | Prescription | ||
Glucocorticoids |
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Bronchodilator Medications
Description: | Prescription | ||
Anticholinergic agents |
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Beta 2-agonists |
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Bronchodilator combinations |
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To learn more about your practice’s current HEDIS performance for this or other measures, or for assistance in compliance with the HEDIS guidelines, please contact Horizon Healthy Journey: 1-844-754-2451.
Reference: NCQA HEDIS Measurement Year (MY) 2022 Technical Specs CPT® is a registered trademark of the American Medical Association.