Prenatal Immunization Status (PRS-E)

HEDIS Measure

Prenatal Immunization Status (PRS-E)

Line of business: Commercial Medicaid

Data Collection Method:

Administrative (Claims)
Supplemental Data Submission

• Standard – Electronic Clinical Data System (ECDS) Layout

Measure Description

The percentage of deliveries in the measurement period in which members had received influenza and tetanus, diphtheria toxoids and acellular pertussis (Tdap) vaccinations.

Numerator Compliance

Numerator 1—Immunization Status: Influenza
Deliveries where members received an adult influenza vaccine on or between July 1 of the year priortothe measurement period and the delivery date.

Numerator 2—Immunization Status: Tdap
Deliveries where members received at least one Tdap vaccine during the pregnancy (including on thedelivery date).

Numerator 3—Immunization Status: Combination
Deliveries that met criteria for both numerator 1 and numerator 2.

Best Practices

• Educate the patient about the importance of follow-up and adherence to treatment recommendations
• Discuss the importance of timely, recommended follow-up visits
• Schedule follow-up appointments as soon as possible, particularly those patients recently discharged
• Coordinate care with behavioral health practitioners by sharing progress notes and updates
• Outreach patients who cancel appointments and assist them with rescheduling as soon as possible
• Consider telemedicine visit when in-person visits are not available
• Discuss the importance of seeking follow-up with a mental health provider
• Develop outreach internal team and/or assign care/case managers to members to ensure memberskeep follow-up appointments or reschedule missed appointments
• Set flags if available in EHR or develop tracking method for patients who may need screenings andfollow-up visits

Quality Value Set Directory Coding Tips

Adult Influenza Immunization

Adult Influenza Vaccine Procedure

Tdap Immunization

Tdap Vaccine Procedure