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:
  1. Dispensed a systemic corticosteroid (or there was evidence of an active prescription) within 14 days of the event.
  2. 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

Bronchodilator Medications

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.