PRIME Clinical Quality Measures Collection

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Practices –

This survey is to provide you with the template for reporting your Clinical Quality Measures to Rocky Mountain Health Plans. When providing your data, please run your measures to reflect calendar year (ex. 1/1/2018 - 12/31/2018)

Comment fields for each measure are provided in order to explain data changes, lack of reporting capabilities, EHR issues, or any other information deemed important by your practice related to your measures data reporting.

If you have any questions related to measurement reporting, Please feel free to contact us via phone or email.

Kim Brown
Manager - Clinical Analytics & Informatics
Office: 970.263.5535
Cell: 970.901.8721
kimberly.brown@rmhp.org

Chelsea Wells
Clinical Informaticist
Office: 970.248.5199
Cell: 970.712.3042
chelsea.wells@rmhp.org

Annie Schudy
Clinical Informaticist
Office: 970.244.7844
Cell: 970.210.0339
annie.schudy@rmhp.org

CLINICAL QUALITY MEASURES:

NQF 0024/CMS 155 - Childhood BMI, Nutrition and Physical Activity Counseling
NQF 59/CMS 122 - Diabetes: Hemoglobin A1c Poor Control
NQF 418/CMS 2 - Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan
NQF 421/CMS 69 - Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
NQF 0004/CMS 137 - Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

For more information regarding the eCQMs, please review the eCQI Resource Center.

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* 1. By completing the box below, I am attesting that the data reflected has been reported out of our practice EMR.

First and Last Name:

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* 2. Practice Name

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* 3. Practice Total Patient Population (include all ages/conditions)

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* 4. NQF 0024/CMS155 - Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Numerator 1:

Denominator 1:

Numerator 2:

Denominator 2:

Numerator 3:

Denominator 3:

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* 5. NQF 0024/CMS155 - Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents: Comments

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* 6. NQF 0059/CMS 122 - Diabetes Hemoglobin A1c Poor Control (Inverted Measure)

Numerator:

Denominator:

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* 7. NQF 0059/CMS 122- Diabetes Hemoglobin A1c Poor Control: Comments

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* 8. NQF 0418/CMS 2 - Clinical Depression Screening

Numerator:

Denominator:

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* 9. NQF 0418/CMS 2- Clinical Depression Screening: Comments

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* 10. NQF 421/CMS 69 - Adult BMI and Follow-Up

Numerator (18+):

Denominator: (18+)

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* 11. CMS 69- Adult BMI and Follow-Up: Comments

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* 12. NQF 0004/CMS 137 - Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

Numerator 1:

Denominator 1:

Numerator 2:

Denominator 2:

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* 1. By completing the box below, I am attesting that the data reflected has been reported out of our practice EMR.First and Last Name:

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* 2. Practice Name

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* 3. Practice Total Patient Population (include all ages/conditions)

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* 4. NQF 0024/CMS155 - Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

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* 5. NQF 0024/CMS155 - Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents: Comments

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* 6. NQF 0059/CMS 122 - Diabetes Hemoglobin A1c Poor Control (Inverted Measure)

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* 7. NQF 0059/CMS 122- Diabetes Hemoglobin A1c Poor Control: Comments

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* 8. NQF 0418/CMS 2 - Clinical Depression Screening

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* 9. NQF 0418/CMS 2- Clinical Depression Screening: Comments

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* 10. NQF 421/CMS 69 - Adult BMI and Follow-Up

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* 11. CMS 69- Adult BMI and Follow-Up: Comments

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* 12. NQF 0004/CMS 137 - Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

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* 13. NQF 0004/CMS 137 - Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

* 1. By completing the box below, I am attesting that the data reflected has been reported out of our practice EMR.

First and Last Name: