Spreadsheet: 737401d1624395207-help-with-index-and-match-functions-that-act-dynamically-example
Sheet: Quality Measure Denominators

Quality Measures of Focus_Health Finch Project_3.30.2021_5.3.2021 |  | grey fill = assumption: using lowest % performance for that care gap
Diabetes Poor Control: EHR based measure. Members between ages 18-75 who are diagnosed with type 1 or type 2 diabetes mellitus that had a most recent hemoglobin A1c (HbA1c) greater than 9 percent
Payor | Membership eligible for measure for 2021 | Membership eligible for measure for 2020 | November 2020 % | December 2020 % | Total number patients receiving care | % patients receiving care | Improvement Opportunity
HealthNet | 305 | 358 | 0.56 | 0.62
IHN-CCO | 1529 | 2010 |  | 0.57
Providence | 362 | 398 | No % Reported Yet | 0.54
Regence | 133 | 151 | 0.54 | 0.54
UHC | 721 | 697 | 0.81 | 0.85
Total patients
Patients with care gaps
Breast Cancer Screening: The percentage of women 50–74 years of age who had a mammogram to screen for breast cancer.
Payor | Membership eligible for measure for 2021 | Membership eligible for measure for 2020 | November 2020 % | December 2020 % | Total number patients receiving care | % patients receiving care | Improvement Opportunity
HealthNet | 625 | 693 | 0.71 | 0.72
Providence | 1151 | 1112 | No % Reported Yet | 0.72
Regence | 151 | 193 | 0.78 | 0.8
Samaritan Advantage | 1170 | Was not a measure in 2020 |  | 0.72
UHC | 1257 | 990 | 0.75 | 0.76
Total patients
Controlling [NAME]: The percentage of members 18–85 years of age who had a diagnosis of hypertension (HTN) and whose BP was adequately controlled (<140/90 mm Hg) during the measurement year.
Payor | Membership eligible for measure for 2021 | Membership eligible for measure for 2020 | November 2020 % | December 2020 % | Total number patients receiving care | % patients receiving care | Improvement Opportunity
HealthNet | 787 | 1160 | 0.57 | 0.64
Regence | 116 | 494 | 0.14 | 0.14
Samaritan Advantage | 1249 | 1808 | 0.66 | 0.67
UHC | 1671 | 1727 | 0.29 | 0.37
Total patients
Medicare Annual Wellness Visits: The Medical Annual Wellness Visit is a no cost benefit offered to all Medicare Part B beneficiaries that aims to identify patient health risks and plan for preventative care need, in an effort to avoid illness, manage chronic conditions, decrease hospitalizations, and decrease unnecessary medical procedures.
Payor | Membership eligible for measure for 2021 | Membership eligible for measure for 2020 | November 2020 % | December 2020 % | Total number patients receiving care | % patients receiving care | Improvement Opportunity
Samaritan Advantage | 4030 | 4030 | 0.36 | 0.45
Providence | 483 | Not a measure in 2020 |  | 0.4
UHC | 5376 | 5307 | 0.34 | 0.4
Regence | 1713 | 1627 | 0.33 | 0.4
Total patients
Well-Child Visits in 3rd,4th, 5th, 6th years of life: Claims based measure.
Payor | Membership eligible for measure for 2021 | Membership eligible for measure for 2020 | November 2020 % | December 2020 % | Total number patients receiving care | % patients receiving care | Improvement Opportunity
IHN-CCO | 4138 | 3430 |  | 0.533
Providence | 330 | 397 | No % Reported Yet | 0.5
MODA | TBA by MODA | 152 | 0.4013 | 0.4934
Total patients
Colorectal Cancer Screening: Patients age 51-75 who have had a resulted colonoscopy within the last 10 years, sigmoidoscopy within the last 5 years, or an FOBT lab result within the last year.
Payor | Membership eligible for measure for 2021 | Membership eligible for measure for 2020 | November 2020 % | December 2020 % | Total number patients receiving care | % patients receiving care | Improvement Opportunity
HealthNet | 1333 | 1429 | 0.67 | 0.71
Regence | 378 | 441 | 0.69 | 0.7
UHC | 2860 | 2432 | 0.74 | 0.77
Total patients
Statin use in persons with Diabetes: Percent of Diabetic eligible population who fill a statin medication during the metric year.
Payor | Membership eligible for measure for 2021 | Membership eligible for measure for 2020 | November 2020 % | December 2020 % | Total number patients receiving care | % patients receiving care | Improvement Opportunity
Providence | 159 | Not a measure in 2020 |  | 0.69
Regence | 57 | 98 | 0.84 | 0.85
UHC | 341 | 723 | 0.8 | 0.8
MODA | TBD by MODA | 105 | 0.6852 | 0.6857
Total patients
SHS | Denominator | Numerator | Improvement Target | Final % |  |  | Improvement Opportunity
Immunizations for Adolescents | 799 | 201 | 0.273 | 0.252
* well child - 5-11 99393; 12-17 99397