– PERFORMANCE MEASURE SETS –
Ambulatory Care Quality Alliance (AQA)
AQA Starter Set

Implementation of these measures included an announcement of a pilot project involving 6 national sites on March 1, 2006 [Word .Doc]. The AQA announced implementation of the Cardiology and Cardiac Surgery starter sets on June 16, 2006 [Word .Doc].

AQA Starter Set
Clinical Measures for Physician Performance
in Ambulatory Care
(AQA document [Word .Doc] and AHRQ review of AQA Starter set)

Performance Measure Clinical Topic			Source of Measure		PVRP Measure		Description
Prevention Measures
1.	Breast Cancer Screening	NCQA	–	Percentage of women who had a mammogram during the measurement year or year prior to the measurement year.
2.	Colorectal Cancer Screening	NCQA	–	The percentage of adults who had an appropriate screening for colorectal cancer. One or more of the following: - FOBT (fecal cccult blood test) during measurement year; - Flexible sigmoidoscopy during the measurement year or the four years prior to the measurement year; - DCBE (double contrast barium enema) during the measurement year or the four years prior; - Colonoscopy during the measurement or nine years prior.
3.	Cervical Cancer Screening	NCQA	X	Percentage of women who had one or more Pap tests during the measurement year or the two prior years.
4.	Tobacco Use	CMS/ AMA	X	Percentage of patients who were queried about tobacco use one or more times during the two-year measurement period.
5.	Advising Smokers to Quit	NCQA	X	Percentage of patients who received advice to quit smoking.
6.	Influenza Vaccination	NCQA	X	Percentage of patients [50-64] who received an influenza vaccination.
7.	Pneumonia Vaccination	NCQA	X	Percentage of patients who ever received a pneumococcal vaccine.
Coronary Artery Disease (CAD)
8.	Drug Therapy for Lowering LDL Cholesterol	CMS/ AMA	X	Percentage of patients with CAD who were prescribed a lipid-lowering therapy (based on current ACC/AHA guidelines).
9.	Beta-Blocker Treatment after Heart Attack	NCQA	X	Percentage of patients hospitalized with acute myocardial infarction (AMI) who received an ambulatory prescription for beta-blocker therapy (within 7 days discharge).
10.	Beta-Blocker Therapy – Post MI	NCQA	X	Percentage patients hospitalized with AMI who received persistent beta-blocker treatment (6 months after discharge).
Heart Failure
11.	ACE Inhibitor /ARB Therapy	CMS/ AMA	X	Percentage of patients with heart failure who also have LVSD who were prescribed ACE inhibitor or ARB therapy.
12.	LVF Assessment	CMS/ AMA	X	Percentage of patients with heart failure with quantitative or qualitative results of LVF assessment recorded.
Diabetes
13.	HbA1C Management	NCQA	X	Percentage of patients with diabetes with one or more A1C test(s) conducted during the measurement year.
14.	HbA1C Management Control	NCQA	X	Percentage of patients with diabetes with most recent A1C level greater than 9.0% (poor control).
15.	Blood Pressure Management	CMS/ AMA	X	Percentage of patients with diabetes who had their blood pressure documented in the past year less than 140/90 mm Hg.
16.	Lipid Measurement	NCQA	X	Percentage of patients with diabetes with at least one Low Density Lipoprotein cholesterol (LDL-C) test (or ALL component tests).
17.	LDL Cholesterol Level (<130mg/dL)	NCQA	X	Percentage of patients with diabetes with most recent LDL-C less than 100 mg/dL or less than 130 mg/dL.
18.	Eye Exam	NCQA	X	Percentage of patients who received a retinal or dilated eye exam by an eye care professional (optometrist or ophthalmologist) during the reporting year or during the prior year if patient is at low risk for retinopathy. A patient is considered low risk if all three of the following criteria are met: (1) the patient is not taking insulin; (2) has an A1C less than 8.0%; and (3) has no evidence of retinopathy in the prior year.
Asthma
19.	Use of Appropriate Medications for People w/ Asthma	NCQA	X	Percentage of individuals who were identified as having persistent asthma during the year prior to the measurement year and who were appropriately prescribed asthma medications (e.g. inhaled corticosteroids) during the measurement year
20.	Asthma: Pharmacologic Therapy	CMS/ AMA	X	Percentage of all individuals with mild, moderate, or severe persistent asthma who were prescribed either the preferred long-term control medication (inhaled corticosteroid) or an acceptable alternative treatment.
Depression
21.	Antidepressant Medication Management, Acute Phase	NCQA	X	Percentage of adults who were diagnosed with a new episode of depression and treated with an antidepressant medication and remained on an antidepressant drug during the entire 84-day (12-week) Acute Treatment Phase.
22.	Antidepressant Medication Management, Continuation Phase	NCQA	X	Percentage of adults who were diagnosed with a new episode of depression and treated with an antidepressant medication and remained on an antidepressant drug for at least 180 days (6 months).
Prenatal Care
23.	Screening for Human Immunodeficiency Virus (HIV)	CMS/ AMA	X	Percentage of patients who were screened for HIV infection during the first or second prenatal visit.
24.	Anti-D Immune Globulin	CMS/ AMA	X	Percentage of D (Rh) negative, unsensitized patients who received anti-D immune globulin at 26-30 weeks gestation.
Quality Measures Addressing Overuse or Misuse
25.	Appropriate Treatment for Children with Upper Respiratory Infection (URI)	NCQA	X	Percentage of patients who were given a diagnosis of URI and were not dispensed an antibiotic prescription on or 3 days after the episode date.
26.	Appropriate Testing for Children with Pharyngitis	NCQA	X	Percentage of patients who were diagnosed with pharyngitis, prescribed an antibiotic and who received a group A streptococcus test for the episode.