Download Disease Activity Measurement for Patients with Rheumatoid Arthritis

Plain Language
1.
a. Measure Title: Disease Activity Measurement for Patients with Rheumatoid Arthritis
(RA)
Description: Percentage of patients 18 years and older with a diagnosis of rheumatoid
arthritis whose disease activity is assessed using a standardized measurement tool at
50% or more encounters for RA with the same clinician during the measurement period.
b. Plain Language Title: Measuring the Severity of Symptoms for Patients with Rheumatoid
Arthritis (RA)
Description: Portion of rheumatoid arthritis patients, aged 18 years and older, who have
had their rheumatoid arthritis symptoms measured, using an approved rheumatology
assessment tool, for at least half of their visits to the same physician
i. A higher score is better because it means that this health care professional
measures the arthritis symptoms for more patients and this helps both the
patient and health care professional monitor the patient’s disease
ii. Monitoring a patient’s symptoms helps the physician better manage the
patient’s disease and reduce the severity of symptoms
iii. To give this health care professional a score, Medicare looked at the percentage
of this health care professional’s patients that have had their symptoms
measures by an approved rheumatology tool, for at least half of their visits
2.
a. Measure Title: Functional Status Assessment for Patients with Rheumatoid Arthritis (RA)
Description: Percentage of patients 18 years and older with a diagnosis of rheumatoid
arthritis whose functional status is assessed using a standardized measurement tool at
least once during the measurement period
b. Plain Language Title: Measuring Function and Movement Capabilities in Patients with
Rheumatoid Arthritis (RA)
Description: Portion of rheumatoid arthritis patients, aged 18 years and older, who have
had their ability to move and complete important daily activities measured by an
approved rheumatology assessment tool at least once during a 12 month period
1. A higher score is better because it means that this health care professional
measures the functionality and movement of rheumatoid arthritis patients
more often
2. Measuring functionality allows the physician to help alleviate severe symptoms
and treat patients according to their abilities to complete daily tasks
3. To give this health care professional a score, Medicare looked at the percentage
of the health care professional’s patients whose functionality was measured
using an approved rheumatology tool at least once during the year
3.
a. Measure Title: Tuberculosis Test Prior to First Course Biologic Therapy
Description: Percentage of patients 18 years and older with a diagnosis of rheumatoid
arthritis that are newly prescribed a biologic medication during the measurement period
and whose medical record indicates tuberculosis testing in the 12 months preceding the
biologic prescription.
b. Plain Language Title: Prior to Being Prescribed A Biologic Drug For The First Time,
Patients Should Have a Tuberculosis Test Performed
Description: Portion of rheumatoid arthritis patients, aged 18 years and older, who have
been administered a tuberculosis test within the year before being prescribed a new
biologic drug to prevent prescribing a biologic drug to patients who might have latent or
hidden tuberculosis
i. A higher score is better because it means that this health care professional
administers a tuberculosis test prior to prescribing the first course of a biologic
medication to more patients
ii. Tuberculosis screenings prior to starting a new biologic medication are
important because patients with tuberculosis can be at increased risk of
dangerous drug side effects and sometimes these infections are not clinically
evident, requiring a special tuberculosis test to identify them
iii. To give this health professional a score, Medicare looked at the percentage of
the health care professional’s patients who had been administered a
tuberculosis test within the year prior to being prescribed their first biologic
medication
4.
a. Measure Title: Glucocorticoids and Other Secondary Causes
Description: Percentage of patients 18 years and older with one of the following
conditions or therapies: receiving oral glucocorticoid therapy for greater than 3 months
OR hypogonadism OR fracture history OR transplant history OR obesity surgery OR
malabsorption disease OR receiving aromatase therapy for breast cancer who had a
central DXA ordered or performed or pharmacologic therapy prescribed within 12
months.
b. Plain Language Title: Patients With Certain Pre-Existing Health Conditions Should Have A
Bone Density Scan Prior to Taking Glucocorticoids (often called ‘steroids’, like
prednisone or similar medications)
Description: Portion of patients, aged 18 years and older, with at least one of the
following:

Being treated with oral glucocorticoid medications for greater than 3
months

Hypogonadism (when the body does not produce enough testosterone)

History of bone fractures

History of organ or bone marrow transplants

History of having undergone obesity surgery

History of malabsorption diseases

Those patients being treated with aromatase therapy for breast cancer
1. A higher score is better because it means that this health care professional provides
bone density screenings to more patients prior to prescribing a glucocorticoid
medication
2. Bone density screenings prior to being prescribed a glucocorticoid are important
because patients are at increased risk for bone loss when taking these medications
3. To give this health care professional a score, Medicare looked at the percentage of
this health care professional’s patients that were given or ordered a bone density
screening within 12 months