2023 TCGP Measure Set list by Domain

The table below displays a listing of the 2023 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 the VBP Roadmap.

Section 1:
2023 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 NFQ 1880 P4P
Antidepressant Medication Management - Effective Acute & Effective Continuation Phase Treatment (AMM) NFQ 0105 P4P
Asthma Medication Ratio (AMR)^ NFQ 1800 P4P
Breast Cancer Screening (BSC-E)^** NFQ 2372 P4P
Cervical Cancer Screening (CCS; CCS-E)** NFQ 0032 P4P
Chlamydia Screening in Women (CHL) NFQ 0033 P4P
Colorectal Cancer Screening (COL; COL-E)^ NFQ 0034 P4P
Controlling High Blood Pressure(CBP)^ NFQ 0018 P4P
COVID-19 Immunization Measure (CVS)* – P4P
Diabetes Screening for People w/ Schizophrenia or Bipolar Disorder Using Antipsychotic Medications (SSD) NFQ 1932 P4P
Eye Exam for Patients With Diabetes (EED) – P4P
Hemoglobin A1c Control for Patients With Diabetes (HBD)^ – P4P
Initiation and Engagement of Alcohol & Other Drug Abuse or Dependence Treatment (IET)^ NQF 0004 P4P
Kidney Health Evaluation for Patients with Diabetes (KED)^^ – P4P
Social Need Screening and Intervention (SNS-E)* – P4R
Section 2:
2023 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 (SAA) NFQ 1879 P4P
Depression Remission or Response for Adolescents and Adults (DRR-E) – P4P
Follow-Up After Emergency Department Visit for Mental Illness (FUM) NFQ 2605 P4P
Follow-Up After Hospitalization for Mental Illness (FUH) NFQ 0576 P4P
Potentially Preventable Mental Health Related Readmission Rate 30 Days – P4P
Section 3:
2023 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 Emergency Department Visit for Substance Use (FUA)^ NQF 3488 P4P
Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) – P4P
Initiation of Pharmacotherapy upon New Episode of Opioid Dependence (POD-N) – P4P
Pharmacotherapy for Opioid Use Disorder (POD)^ – 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:
2023 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 (HIV-AD) NFQ 2082 P4P
Section 5:
2023 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 (PPC)^ NFQ 1517 P4P
Section 6:
2023 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 (PDI 14) NFQ 0728 P4P
Child and Adolescent Well-Care Visits (WCV)^ – P4P
Childhood Immunization Status - Combination 3 (CIS; CIS-E) NFQ 0038 P4P
Immunizations for Adolescents - Combination 2 (IMA)^ NFQ 1407 P4P
Well-Child Visits in the First 30 Months of Life (W30)^ – P4P

*New Measure for MY2023
**Measure Revised for MY2023
^ HEDIS Stratified Measure