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1 Attachment #1: Examples of Encounter Data • • • • • • • • • • • Health Plan ID Beneficiary ID Date of Service Place of Service Provider Name Provider Number Prior Authorizations Referrals Diagnosis Codes Procedure Codes Medications/Prescriptions • • • • • • • • Surgical Codes Admission Dates Discharge Dates Patient Status Code Long-term care Number of days X-Rays and Imaging Laboratory Services “What diagnosis was made? What tests were performed? What treatments were provided?” 2 Attachment #2: HEDIS Measurements • • • • • • • • Well-Child Visits (Years 3-6) Adolescent Well-Care Visits Childhood Immunization StatusCombo 3 Prenatal & Postpartum Care (Timeliness of Prenatal Care, Postpartum Care) Use of Imaging Studies for Low Back Pain Cervical Cancer Screening Weight Assessment & Counseling for Nutrition & Physical Activity for Children & Adolescents Comprehensive Diabetes Care (e.g. Eye exam, LDL-C screening & control, HbA1c testing & control, medical attention for Nephropathy, blood pressure) • • • • • • • Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis HbA1c Testing indicator used for Auto Assignment (Diabetes) Children & Adolescents' Access to Primary Care Practitioners* Immunizations for Adolescents* Ambulatory care: Outpatient visits, Emergency Department visits* Annual Monitoring for Patients on Persistent Medications (w/out anticonvulsant indicator)* All-Cause Readmissions Statewide Collaborative QIP measure* * New for 2012