Continuous Improvement and the Expansion of Quality ... - NCQA

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T H E S TAT E o f H E A l T H C A R E Q U A l I T y 2 0 1 1 • H E D I S M E A S U R E S o f C A R E GlAUCoMA SCREENING IN olDER ADUlTS Glaucoma represents a family of diseases commonly associated with optic nerve damage and changes in the visual field (narrowing of the eyes’ usual scope of vision). Disease development is gradual, starting with “blind spots” and progressing up to complete blindness, with little or no warning signs or symptoms. 1 The Glaucoma Screening in Older Adults measure assesses whether older adults received an eye exam to check for this condition. • Elevated eye pressure and older age are key risk factors. With an aging population, the prevalence and incidence of glaucoma continue to rise. 2,3 • Untreated glaucoma is the second leading cause of irreversible blindness in the U.S. 1,2 • Among African Americans, glaucoma is the leading cause of blindness—African Americans are six to eight times more likely than Caucasians to have glaucoma. 3,4 the Case for Improvement • Managed care organizations spend approximately $1 billion ($2,000 per patient) annually to treat glaucoma. Treatment costs increase significantly as the disease progresses. 6 • At least 4.2 million people in the United States have glaucoma, but only half of them know that they have it. Another 5–10 million have elevated eye pressure and are at risk of developing glaucoma. 5 113 • Glaucoma-associated visual impairment affects the quality of life and the ability to function independently, hampering basic daily activities. Vision loss among the elderly has been shown to result in social isolation, family stress and a greater tendency to experience other health conditions. 2,3 HEdIs Measure definition The percentage of Medicare adults 65 years and older without a prior diagnosis of glaucoma or glaucoma suspect, who received a glaucoma eye exam by an eyecare professional for the early identification of glaucomatous conditions. M E A S U R E S T A R G E T E D A T o l D E R A D U l T S
M E A S U R E S T A R G E T E D A T o l D E R A D U l T S 114 N AT I o N A l C o M M I T T E E f o R Q U A l I T y A S S U R A N C E results Glaucoma’s asymptomatic progression points to the importance of early detection and treatment, which can prevent, slow or stop vision loss. 6 yEAR sCrEEnIng ratE CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 NA NA 63.8 65.1 NA 2009 NA NA 62.3 63.7 NA 2008 NA NA 59.8 62.2 NA 2007 NA NA 59.5 62.6 NA 2006 NA NA 62.2 63.3 NA 2005 NA NA 61.5 64.5 NA
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4 N AT I o N A l C o M M I T T E E
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16 this measure has shown steady ga
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24 HEDIS MEASURES of CARE about HEd
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S A f E T y A N D P o T E N T I A l
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W E l l N E S S A N D P R E V E N T
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C H R o N I C D I S E A S E M A N A
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Page 131 and 132: 130 APPENDIx 1: HEDIS EffECTIVENESS
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164 N AT I o N A l C o M M I T T E
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172 MEASURE N AT I o N A l C o M M
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180 APPENDIx 16A: VARIATIoN IN PlAN
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182 APPENDIx 16b: VARIATIoN IN PlAN
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184 REfERENCES N AT I o N A l C o M
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ACkNoWlEDGMENTS Health Plans The 20
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Continuous Improvement and the Expansion of Quality ... - NCQA

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