8 Tobacco Use: Screening and Cessation Intervention Percentage of ACO Attributed Members ages 18 to 64 who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user. X American Medical Association on behalf of the Physician Consortium for Performance Improvement® - Medical Specialty Society 0028
9 BMI Assessment Percentage of ACO Attributed Members ages 18 to 64 who had an outpatient visit and who had their body mass index (BMI) documented during the measurement year or the year prior to the measurement period X NCQA - ACO N/A
11 Controlling High Blood Pressure Percentage of ACO Attributed Members 18 to 64 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled during the measurement period, based on age/condition-specific criteria X NCQA - ACO 0018
12 COPD or Asthma Admission Rate in Adults All discharges with a principal diagnosis code for COPD or asthma in adults ages 40 to 64, for ACO Attributed Members with COPD or asthma, with comparison of observed discharges to expected discharges for each ACO. X CMS N/A
15 Diabetes Short-Term Complications Admission Rate Admissions for a principal diagnosis of diabetes with complications (ketoacidosis, hyperosmolarity, or coma) per 100,000 ACO Attributed Members months ages 18 to 64. Excludes obstetric admissions and transfers from other institutions. X CMS 0272
21 Follow-Up After Hospitalization for Mental Illness (7-day) Percentage of discharges for ACO Attributed Members ages 6 to 64 who were hospitalized for treatment of selected mental illness diagnoses and who had an outpatient visit, an intensive outpatient encounter or partial hospitalization with a mental health practitioner within 7 days of discharge. X NCQA - ACO 0576
22 Follow-up care for children prescribed ADHD medication - Initiation Phase Percentage of ACO Attributed Members 6 to 12 years of age as of the index prescription start date (IPSD) with an ambulatory prescription dispensed for ADHD medication who had one follow-up visit with a practitioner with prescribing authority during the initiation phase. X NCQA - ACO 0108 day
30 Emergency Department Care Coordination of ED Boarding Population Percentage of ACO Attributed Members boarding in the ED for whom a referral was made by the ED to the PCP or Community Partner (CP) upon discharge. Boarding defined as ≥ 48 hours in the ED. X N/A
If the Contractor’s TCOC Performance is lower than the Contractor’s TCOC Benchmark (i.e., the Contractor has Savings), as described in Section 2.7 of the Contract, the Contractor’s TCOC component of its DSRIP Accountability Score equals 100% If the Contractor’s TCOC Performance exceeds the Contractor’s TCOC Benchmark by more than 5% of the Contractor’s TCOC Benchmark, as described in Section 2.7 of the Contract, the Contractor’s TCOC component of its DSRIP Accountability Score equals 0% If the Contractor’s TCOC Performance exceeds the Contractor’s TCOC Benchmark by less than 5% of the Contractor’s TCOC Benchmark, the Contractor’s TCOC component of its Accountability Score equals: one (1) minus (the Contractor’s TCOC Performance minus the Contractor’s TCOC Benchmark) / (5% of the Contractor’s TCOC Benchmark) Quality performance The Contractor’s quality component of the DSRIP Accountability Score will be the exact same number as the Contractor’s Quality Score, as described in Section 2. DSRIP Accountability Score EOHHS will calculate the Contractor’s DSRIP Accountability Score by multiplying the Contractor’s TCOC component of its DSRIP Accountability Score (as calculated in Section 3.2 above) and the Contractor’s quality component of its DSRIP Accountability Score (as described in Section 3.3 above) by the domain weights in Exhibit 8 above, and summing the resulting amounts together. The resulting number is the Contractor’s DSRIP Accountability Score, which will be a number between zero (0) and one (1), inclusive.