DRAFT 2020 Proposed TCGP VBP Quality Measures

The table below displays a listing of the 2020 Total Care for General Population VBP Quality Measures by domain (e.g., Primary Care, Mental Health, Substance Use Disorder, HIV/AIDS, Maternity, Children´s) that are required for inclusion in TCGP VBP contract development based on proposed VBP Roadmap updates.

Section 1:
Proposed 2020 Primary Care Measures
You must choose at least 1 measure from the following domain to be included in the VBP Contract.
Measure Name ID Class
Adherence to Mood Stabilizers for Individuals with Bipolar I Disorder NQF 1880 P4P
Antidepressant Medication Management – Effective Acute Phase Treatment & Effective Continuation Phase Treatment NQF 0105 P4P
Asthma Medication Ratio NQF 1800 P4P
Breast Cancer Screening NQF 2372 P4P
Cervical Cancer Screening NQF 0032 P4P
Chlamydia Screening in Women NQF 0033 P4P
Colorectal Cancer Screening NQF 0034 P4P
Comprehensive Diabetes Care: Eye Exams NQF 0055 P4P
Comprehensive Diabetes Care: Hemoglobin A1c (HbA1c) Poor Control (>9.0%) NQF 0059 P4P
Comprehensive Diabetes Care: Medical Attention for Nephropathy NQF 0062 P4P
Controlling High Blood Pressure NQF 0018 P4P
Diabetes Screening for People w/ Schizophrenia or Bipolar Disorder Using Antipsychotic Medications NQF 1932 P4P
Initiation and Engagement of Alcohol & Other Drug Abuse or Dependence Treatment (IET) NQF 0004 P4P
Medication Management for People with Asthma NQF 1799 P4P
Section 2:
Proposed 2020 Mental Health Measures
You must choose at least 1 measure from the following domain to be included in the VBP Contract.
Measure Name ID Class
Adherence to Antipsychotic Medications for Individuals with Schizophrenia NQF 1879 P4P
Depression Remission or Response for Adolescents and Adults – P4P
Follow–Up After Emergency Department Visit for Mental Illness NQF 2605 P4P
Follow–Up After Hospitalization for Mental Illness NQF 0576 P4P
Potentially Preventable Mental Health Related Readmission Rate 30 Days – P4P
Section 3:
Proposed 2020 Substance Use Disorder Measures
You must choose at least 1 measure from the following domain to be included in the VBP Contract.
Measure Name ID Class
Follow–Up After High–Intensity Care for Substance Use Disorder (FUI) – P4P
Follow–Up After Emergency Department Visit for Alcohol and Other Drug Dependence NQF 2605 P4P
Initiation of Pharmacotherapy upon New Episode of Opioid Dependence – P4P
Pharmacotherapy for Opioid Use Disorder (POD) NQF 3175 P4P
Unless you are excluding or carving out HIV+ individuals, pregnant women, or children members in your TCGP arrangement, you must choose at least one Category 1 P4P measure from each of the applicable domains below*.
Section 4:
Proposed 2020 HIV/AIDS Measure*
You must choose at least 1 measure from the following domain to be included in the VBP Contract.
Measure Name ID Class
HIV Viral Load Suppression NQF 2082 P4P
Section 5:
Proposed 2020 Maternity Measures*
You must choose at least 1 measure from the following domain to be included in the VBP Contract.
Measure Name ID Class
Prenatal and Postpartum Care NQF 1517 P4P
Section 6:
Proposed 2020 Children´s Measures*
You must choose at least 1 measure from the following category to be included in the VBP Contract.
Measure Name ID Class
Asthma Admission Rate – PDI #14 NQF 0728 P4P
Childhood Immunization Status – Combination 3 NQF 0038 P4P
Immunizations for Adolescents – Combination 2 NQF 1407 P4P
Well–Child Visits in the First 15 Months of Life NQF 1392 P4P
Well–Child Visits in the Third, Fourth, Fifth, and Sixth Year of Life NQF 1516 P4P