Product Lines:
Advantage MD, Dual Eligible Special Needs Plans (D-SNP), EHP, Priority Partners, and USFHP.

Eligible Population:
Members 40 years of age and older as of December 31 of the measurement year.

Definition:
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 and November 30 and were dispensed appropriate medications. Two rates are reported:

• Dispensed a systemic corticosteroid (or there was evidence of an active prescription) on or within 14 days of the event - COPD exacerbation.
• Dispensed a bronchodilator (or there was evidence of an active prescription) within 30 days of the event.

Note: The eligible population for this measure is based on acute inpatient discharges and ED visits, not on members. It is possible for the denominator to include multiple events for the same individual.

Continuous Enrollment:

• The measurement year and the year prior to the measurement year.

Best Practice and Measure Tips

• Members with active prescriptions for these medications are administratively compliant with the measure.
• An active prescription is one that’s noted as having available medication left in the “days’ supply” through the episode date or further.
• The “episode date” for an acute inpatient stay is the admission date.
• The “episode date” for the emergency department visit is the date of service. 
• Follow up with members to make sure any new prescriptions are filled post-discharge.

Measure Exclusions

Required Exclusion:

• Members in hospice or using hospice services anytime during the measurement year.
• Members who died any time during the measurement year

Measure Medications

• Systemic Corticosteroid Medications on or 14 days after the Episode Date.

• Bronchodilator Medications on or 30 days after the Episode Date.