HEDIS Asthma Measures Seek to Improve Health Outcomes

When treating patients with persistent asthma, it’s important to monitor whether they are using the appropriate medications and in the correct ratio. NCQA/HEDIS asthma measures provide important benchmarks for ensuring optimal health outcomes in these patients.

One measure examines the ratio of controller medication to the total of controller and reliever medications. The goal is to achieve a ratio of controller medication to total medication of 50 percent or greater for the duration of treatment. The other measure looks at the percentage of time patients remain on a controller medication for their asthma, which, according to the HEDIS measure, should be at least 50 percent. Medication samples provided from the office are not included in any of these calculations; only claims information is used.

You can take steps to ensure that your patients keep their asthma in control.

• Connect your patients to our asthma educators. Contact our single-source referral line at 1-888-94-CDPHP (23747).
• Help your patient develop an asthma action plan, which typically includes the following:
  • Treatment goals, which include your patient’s personal goals as they relate to asthma.
  • A list of the daily medicines that should be taken for asthma control and the appropriate frequency for their administration.
  • An asthma diary so your patient can keep track of their symptoms, triggers, and other strategies for managing the condition.
  • Steps to take and medicines to use to treat an asthma attack early, before it becomes severe.
  • Instructions for what to do if an attack becomes an emergency, and where to get medical treatment.
• Review medications at each visit, and focus on members who have not filled their prescription for controller medication.
• Utilize the Rx for Less program for medications, if appropriate.

For additional strategies for success with these HEDIS measures and others, refer to the 2019 HEDIS Tips Booklet for Providers found on the CDPHP provider portal under Provider Resources and HEDIS Information.