Annually, IHP physician leaders set operational and clinical goals to show evidence of our commitment to high quality, affordable care.
View the 2024 Metrics Completion List Tracking Sheet (updated 9/6/24)
| 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% |
