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Metrics

2024 INTEGRIS Health Partners Metrics

View the 2024 Metrics Completion List Tracking Sheet (updated 6/10/24)

Domain Measure Notes Weight Measurement Level Partial Target  Full Target
Access to Care: New Members Seen (Commercial) Calculates the % of newly attributed patients who had a PCP visit during the measurement period 5% PCP 60.0% 70.0%
Access to Care: New Members seen (MA) Calculates the % of newly attributed patients who had a PCP visit during the measurement period 5%   PCP 70.0% 80.0%
Access to Care:  Established Members Seen (commercial) Calculates the % of established patients who had a PCP visit during the measurement period 5% PCP 60.0% 70.0%
Access to Care:  Established Members Seen(MA)  Calculates the % of established patients who had a PCP visit during the measurement period  5% PCP  70.0%  80.0% 
Access to Care:  Annual Wellness Visit (CMS Definition for MSSP) Measured at the PCP level, attributed patients age 65+ who have had an annual wellness visit (specific CPT codes) within the measurement period (YTD) 5% PCP 70.0% 80.0%
Quality: Diabetes: A1C Screening  Attributed value-based patients 18-35 diagnosed with diabetes who have had an A1c screening within the measurement period. 10% PCP 80.0% 90.0%
Quality  Kidney Evaluation Attributed value-based patients 18-35 diagnosed with diabetes who have had a kidney health evaluation within the measurement period (YTD) as defined by: Estimated glomerular filtration rate Urine albumin-creatinine ratio Test DOS must be four or fewer days apart 10% PCP 42.0% 50.0%
Utilization: Outpatient ED Visits/1000 (Commercial) ED visits that did not result in an admission 5% TIN 200 175
Utilization: Outpatient ED Visits/1000 (Medicare) ED visits that did not results in an admission 5% TIN 560 530
Utilization: HEDIS 30 Day All Cause Readmission (Commercial) Attributed value-based patients 18+ with an unplanned acute readmission for any diagnosis within 30-days of an acute hospital discharge 10% TIN 5.0% 3.0%
Utilization: HEDIS 30 Day All Cause Readmission (Medicare) Attributed value-based patients 18+ with an unplanned acute readmission for any diagnosis within 30-days of an acute hospital discharge
10% TIN 10.0% 8.0%
Citizenship: Attend at least 50% of POD meetings POD Meeting Attendance 10% PCP NA 50.0%
Risk: Chronic Condition Follow-up Index (CCFI) The percentage of high priority chronic conditions addressed at an encounter during the designated measurement period 15% PCP 80.0% 90.0%

 

 Domain Pediatric Care Measures Weight Measurement Level Partial Target Full Target
Access to Care:  Well-Child visits 6+ (0-15 months old) 15% PCP 70% 80%
Access to Care: Well-Child visits 2+ (15-30 months old) 15% PCP  75% 86%
Access to Care:  Child & Adolescent Well-Care Visits 1 (3-11 years old) 10% PCP 55% 65%
Quality:  Pharyngitis: Appropriate Testing (3-17 years) 15% PCP 75% 82%
Quality: URI: No Antibiotic Treatment (3 months - 17 years) 15% PCP 83% 93%
Utilization: Outpatient ED Visits/1000 (Commercial) 15% TIN 195 175
Citizenship: Attend at least 50% of POD Meetings 15% PCP NA 50.0%