2025 Total Care for General Population (TCGP) VBP Quality Measures
The table below displays a listing of the 2025 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 a TCGP VBP contract development based on the VBP Roadmap.
| 2025 Primary Care Measures You must choose at least 1 measure from the following domain to be included in the VBP Contract. |
|
|---|---|
| Measure Name | Class |
| Adult Immunization Status - Electronic (Influenza)(AIS-E)^ | |
| Asthma Medication Ratio (AMR) | P4P |
| Breast Cancer Screening (BCS-E) | P4P |
| Cervical Cancer Screening ( |
P4P |
| Chlamydia Screening |
P4P |
| Colorectal Cancer Screening (COL-E) | P4P |
| Controlling High Blood Pressure (CBP) | P4P |
| COVID-19 Immunization Measure (CVS)^ | P4P |
| Depression Screening and Follow-Up for Adolescents and Adults (DSF-E)* | P4R |
| Diabetes Screening for People w/ Schizophrenia or Bipolar Disorder Using Antipsychotic Medications (SSD) | P4P |
| Eye Exam for Patients With Diabetes (EED)^ | P4P |
| Glycemic Status Assessment for Patients with Diabetes (GSD) | P4P |
| Initiation and Engagement of Substance Use Disorder Treatment (IET) | P4P |
| Kidney Health Evaluation for Patients with Diabetes (KED)^ | P4P |
| Social Need Screening and Intervention (SNS-E)^ | P4R |
| 2025 Mental Health Measures You must choose at least 1 measure from the following domain to be included in the VBP Contract. |
|
| Measure Name | Class |
| Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA) | P4P |
| Depression Remission or Response for Adolescents and Adults (DRR-E) | P4P |
| Follow-Up After Emergency Department Visit for Mental Illness (FUM) | P4P |
| Follow-Up After Hospitalization for Mental Illness (FUH) | P4P |
| Potentially Preventable Mental Health Related Readmission Rate 30 Days (PPR-MH) | P4P |
| 2025 Substance Use Disorder Measures You must choose at least 1 measure from the following domain to be included in the VBP Contract. |
|
| Measure Name | Class |
| Follow-Up After Emergency Department Visit for Substance Use (FUA) | 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, and/or child members in your TCGP
arrangement, you must choose at least one Category 1 P4P measure from each of the applicable domains below.
| 2025 People Living with HIV/AIDS Measure** You must choose at least 1 measure from the following domain to be included in the VBP Contract. |
|
|---|---|
| Measure Name | Class |
| HIV Viral Load Suppression (VLS) | P4P |
| 2025 Maternity Measures** You must choose at least 1 measure from the following domain to be included in the VBP Contract. |
|
| Measure Name | Class |
| Prenatal and Postpartum Care (PPC) | P4P |
| Prenatal Immunization Status (PRS-E)^ | |
| 2025 Children's Measures** You must choose at least 1 measure from the following category to be included in the VBP Contract. |
|
| Measure Name | Class |
| Child and Adolescent Well-Care Visits (WCV) | P4P |
| Childhood Immunization Status - Combination 3 ( |
P4P |
| Developmental Screening Using Standardized Tool, First Three Years of Life (DEV-N)^ | |
| Immunizations for Adolescents - Combination 2 ( |
P4P |
| Oral Evaluation, Dental Services (OED) | P4R |
| Topical Fluoride for Children (TFC) | P4R |
| Well-Child Visits in the First 30 Months of Life (W30) | P4P |
^ Measure Revised for MY2025
Retired/Removed for MY2025
*Revised for MY2025 - ECDS (HEDIS Electronic Clinical Data Systems) Reporting ONLY
*New Measure for MY2025
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