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 the measurement year and the year prior to the measurement year and had each of the following during the measurement year: • lDl-C screening • lDl-C control (
C H R o N I C D I S E A S E M A N A G E M E N T 58 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 DISEASE MoDIfyING ANTI-RHEUMATIC DRUG THERAPy IN RHEUMAToID ARTHRITIS Rheumatoid arthritis (RA) is a chronic inflammatory disease in which the immune system attacks healthy joints. 1 It causes joint destruction, bone erosion and damage to muscles, kidneys and other organs. 2 RA affects 1.5 million Americans. 3 The Disease Modifying Anti-Rheumatic Drug Therapy (DMARD) in Rheumatoid Arthritis measure assesses whether RA patients receive medications that slow the disease’s progression and help them maintain functional capacity longer. • People with persistent RA are at greater risk for premature death. 4 In particular, people with RA die from heart-related problems at higher rates than people without RA. 5 • Arthritis and other rheumatic conditions are the most common causes of disability in the United States. Approximately 850,000 adults reported being disabled by RA—more than blindness, deafness, bone fracture, cancer and diabetes combined. 6 • Although there is no cure for RA, DMARDs may effectively protect joints and minimize inflammation, slowing progression of the disease and reducing pain. 7 the Case for Improvement • Arthritis and related conditions, including RA, cost the U.S. economy $128 billion each year. Direct costs, like medical expenses, are estimated at $81 billion, and indirect costs, such as lost wages and disability payments, are estimated at $47 billion. 8 • In 2009, RA was the principal diagnosis in over 16,000 hospitalizations. on average, each visit lasted 4 days and cost nearly $36,000. 9 • Approximately 60 percent of people with RA become too ill to work after 10 years of the disease. 10 HEdIs Measure definition The percentage of diagnosed adults with rheumatoid arthritis who were dispensed at least one ambulatory prescription for a DMARD.
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128 N AT I o N A l C o M M I T T E
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130 APPENDIx 1: HEDIS EffECTIVENESS
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134 APPENDIx 2: HEDIS EffECTIVENESS
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150 APPENDIx 6b: ACCREDITED VS. NoN
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152 APPENDIx 7A: PUblICly REPoRTING
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158 APPENDIx 8: PUblICly REPoRTING
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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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