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)^ P4R P4P
Antidepressant Medication Management - Effective Acute & Continuation Phase Treatment (AMM) P4P
Asthma Medication Ratio (AMR) P4P
Breast Cancer Screening (BCS-E) P4P
Cervical Cancer Screening (CCS; CCS-E)* P4P
Chlamydia Screening in Women (CHL)^ 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)^ P4R P4P
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 (CIS; CIS-E)* P4P
Developmental Screening Using Standardized Tool, First Three Years of Life (DEV-N)^ P4R P4P
Immunizations for Adolescents - Combination 2 (IMA, IMA-E)* 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