Percentage of patients aged 1 year and older who underwent an otolaryngologic surgical procedure and did not receive perioperative or postoperative antibiotics when there were no clinical indications, based on evidence-based guidelines.
Measure Type: High Priority
Measuring the Value-Functions of Primary Care: Physician Level Continuity of Care Measure
The measure calculates the percentage of a physician’s patients who have a continuity index of at least 0.7 (excluding patients with < 2 primary care visits during the measurement period). This is a physician-level measure for use in evaluating physician behavior; it leverages a previously validated continuity index that quantifies the extent to which patients experience continuity of provider in their primary care visits.
This measure evaluates the extent to which primary care physicians (PCPs) are supporting the continuity of care of their patients. High care continuity is shown to improve patient outcomes and physician well-being, is associated with decreased health care costs (total, ED, inpatient, primary care, and costs for specific conditions or treatments) and health care utilization (ED visits and hospitalizations). As a byproduct of building a trusting relationship over time, issues of equity and social risk can be addressed. Physicians who perform better are likely to have specific structures and processes in place that are conducive to allowing patients to achieve higher care continuity.
Compared to lower scores (e.g., 0.6 or lower), continuity index scores of 0.7 or higher have been associated with significantly lower Medicare expenditures and significantly lower odds of hospitalization.1
References:
1. Higher Primary Care Physician Continuity is Associated with Lower Costs and Hospitalizations. Bazemore et al. Annals of Family Medicine. 2018. 16, 492-497.
Melanoma: – Appropriate Surgical Margins
Percentage of primary excisional surgeries for melanoma or melanoma in situ with Breslow depth and appropriate surgical margins per the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology- Melanoma (NCCN Guideline).
Avoidance of Post-operative Systemic Antibiotics for Office-based Closures and Reconstruction After Skin Cancer Procedures
Percentage of procedures in patients aged 18 and older with a diagnosis of skin cancer who underwent intermediate layer or complex linear closure or reconstruction after skin cancer resection in the office-based* setting who were prescribed post-operative systemic antibiotics to be taken immediately following reconstruction surgery (inverse measure).
This measure is stratified by intermediate layer or complex linear closure or reconstructive procedures.
Actinic Keratosis: Patient-Reported Treatment Effectiveness and Care Satisfaction
Percentage of adult patients (greater than or equal to 18 years old) who self-report favorable outcomes resulting from a recommended treatment or management approach for Actinic Keratosis (AK) and who self-report satisfaction with the treatment or management of AK. Patients provide a global assessment of the perceived effectiveness of the AK treatment or management plan, followed by their satisfaction and future treatment preference. Evaluating both treatment effectiveness and patient satisfaction supports patient-provider communication and promotes patient-centered approaches to AK care.
Actinic Keratosis: Appropriate Documentation and Shared Decision Making of AK
Percentage of adult patients (>18 years old) diagnosed with Actinic Keratosis (AK) whose healthcare provider has recorded the following information in the patient’s medical record 1) documentation of the number or range of AKs, 2) location(s) of AK, 3) documentation of prior squamous cell carcinoma, or prior keratinocyte carcinomas and types if known, 4) age, 5) gender, and 6) immunosuppression and have engaged in bi-directional communication with the patient regarding the risk of malignant transformation and a discussion of at least two options for managing AK.
Tympanostomy Tubes: Topical Ear Drop Monotherapy for Acute Otorrhea
Percentage of patients aged 6 months to 12 years of age at the time of the visit with a current diagnosis of an uncomplicated acute tympanostomy tube otorrhea (TTO) who were prescribed or recommended to use topical antibiotic eardrops and NOT prescribed systemic (IV or PO) antibiotics for acute TTO
Bell’s Palsy: Inappropriate Use of Magnetic Resonance Imaging or Computed Tomography Scan
Percentage of patients aged 16 years and older with a new onset diagnosis of Bell’s palsy who had a magnetic resonance imaging (MRI) or a computed tomography (CT) scan of the internal auditory canal, head, neck, or brain ordered within 3 months after diagnosis
Age-Related Hearing Loss: Comprehensive Audiometric Evaluation
Percentage of patients aged 50 years and older who failed a hearing screening and/or who report suspected hearing loss who received, were ordered, or were referred for comprehensive audiometric evaluation within 4 weeks of the office visit
Chronic Skin Conditions: Patient Reported Quality-of-Life
The percentage of patients aged 18 years and older with a chronic skin condition whose self-assessed quality-of-life was recorded at least once in the medical record within the measurement period.