After reading Chapter 1 through 4, you should be familiar with quality improvement initiatives including the National Committee for Quality Assurance (NCQA) HEDIS & Quality Measurement: HEDIS Measures. (Links to an external site.) Health plans and physicians must ensure they are meeting standards set by the accreditation agencies, such as NCQA. As a physician practice manager for Dr. Jones, you have just conducted a mock survey of the patient chart data. The data shows that your physician practice is not meeting standards for two HEDIS measures. Choose two HEDIS measures from the list below that must be implemented in a physician practice to improve patient outcomes. You must describe the sources of data needed to conduct the two measures. What source would you use obtain the data? For example, if we were to look at patients receiving a beta blocker after discharge from the hospital, we would obtain data from pharmacy claims. Using one of the quality improvement models (i.e., Lean, PDSA, or Six Sigma), explain how you would use the model to implement one of the chosen HEDIS measures. Include information on how the quality initiatives chosen are linked to the rising costs of health care. Consider government mandates that have improved quality initiatives related to implementing the HEDIS measures or added to the burden of increased costs. Your initial post should be 250 to 300 words and utilize at least one scholarly source from the Ashford University Library to justify your choice of improvement models. Cite all sources in APA format as outlined in the Ashford Writing Center’s Introduction to APA (Links to an external site.) . NCQA HEDIS Measures Anti-Depressant Medication Management (AMM) Assesses adults 18 years of age and older with a diagnosis of major depression who were newly treated with antidepressant medication and remained on their antidepressant medications. Two rates are reported: Effective Acute Phase Treatment: Adults who remained on an antidepressant medication for at least 84 days (12 weeks). Effective Continuation Phase Treatment: Adults who remained on an antidepressant medication for at least 180 days (6 months). Cervical Cancer Screening: Assesses women 21–64 years of age who were screened for cervical cancer using either of the following criteria: Women age 21–64 who had cervical cytology performed every 3 years. Women age 30–64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years. Colorectal Screening: Assesses adults 50–75 who had appropriate screening for colorectal cancer with any of the following tests: annual fecal occult blood test, flexible sigmoidoscopy every 5 years, colonoscopy every 10 years, computed tomography colonography every 5 years, stool DNA test every 3 years. Hypertension/Cardiovascular: Assesses patients who were hospitalized and discharged alive after an acute Myocardial Infarction (heart attack) who received tre.

1. After reading Chapter 1 through 4, you should be familiar with
quality improvement initiatives including the National
Committee for Quality Assurance (NCQA)
HEDIS & Quality Measurement: HEDIS Measures. (Links to an
external site.)
Health plans and physicians must ensure they are meeting
standards set by the accreditation agencies, such as NCQA. As a
physician practice manager for Dr. Jones, you have just
conducted a mock survey of the patient chart data. The data
shows that your physician practice is not meeting standards for
two HEDIS measures.
Choose two HEDIS measures from the list below that must be
implemented in a physician practice to improve patient
outcomes.
You must describe the sources of
data
needed to conduct the two measures. What source would you
use obtain the data? For example, if we were to look at patients
receiving a beta blocker after discharge from the hospital, we
would obtain data from pharmacy claims.
Using one of the quality improvement models (i.e., Lean,
PDSA, or Six Sigma), explain how you would use the model to
implement one of the chosen HEDIS measures.
Include information on how the quality initiatives chosen are
linked to the rising costs of health care. Consider government
mandates that have improved quality initiatives related to
implementing the HEDIS measures or added to the burden of
increased costs.

2. Your initial post should be 250 to 300 words and utilize at least
one scholarly source from the Ashford University Library to
justify your choice of improvement models. Cite all sources in
APA format as outlined in the Ashford Writing Center’s
Introduction to APA (Links to an external site.)
.
NCQA HEDIS Measures
Anti-Depressant Medication Management (AMM)
Assesses adults 18 years of age and older with a diagnosis of
major depression who were newly treated with antidepressant
medication and remained on their antidepressant medications.
Two rates are reported:
Effective Acute Phase Treatment:
Adults who remained on an antidepressant medication for at
least 84 days (12 weeks).
Effective Continuation Phase Treatment:
Adults who remained on an antidepressant medication for at
least 180 days (6 months).
Cervical Cancer Screening:
Assesses women 21–64 years of age who were screened for
cervical cancer using either of the following criteria:

3. Women age 21–64 who had cervical cytology performed every 3
years.
Women age 30–64 who had cervical cytology/human
papillomavirus (HPV) co-testing performed every 5 years.
Colorectal Screening:
Assesses
adults 50–75 who had appropriate screening for colorectal
cancer
with any of the following tests: annual fecal occult blood test,
flexible sigmoidoscopy every 5 years, colonoscopy every 10
years, computed tomography colonography every 5 years, stool
DNA test every 3 years.
Hypertension/Cardiovascular:
Assesses patients who were hospitalized and discharged alive
after an acute Myocardial Infarction (heart attack) who received
treatment with beta-blockers for six months after discharge.
Assesses patients 18 to 85 with a diagnosis of hypertension
whose most recent blood pressure reading was controlled.
Age 18 to 59 whose BP was <140/90

4. Age 60 to 85 with a diagnosis of diabetes whose BP was
<140/90
Age 60 to 85 without a diagnosis of diabetes whose BP was
<150/90
Immunization Status:
Adolescents:
Assesses adolescents 13 years of age who had one dose of
meningococcal vaccine, one Tdap vaccine and the complete
human papillomavirus vaccine series by their 13th birthday.
Children:
Assessed the percentage of children 2 years of age who had a
four diphtheria, tetanus and acellular pertussis (DTaP); three
polio (IPV); one measles, mumps and rubella (MMR); three
haemophilus influenza type B (HiB); three hepatitis B (HepB),
one chicken pox (VZV); four pneumococcal conjugate (PCV);
one hepatitis A (HepA); two or three rotavirus (RV); and two
influenza (flu) vaccines by their second birthday.
Mammograms:
Women age 50 to 74 years who have had a mammogram during
the preceding 24 months. Exclusion of those women who have
undergone bilateral mastectomy.

5. Non- Recommended PSA:
Assess whether men 70 years of age and older were screened
unnecessarily for prostate cancer using prostate-specific antigen
(PSA)-based screening.
Osteoporosis Testing and Management in Older Women:
Osteoporosis Testing in Older Women:
This survey-based measure assesses women 65–85 years of age
who report ever having received a bone density test to check for
osteoporosis.
Osteoporosis Management in Women Who Had a Fracture:
Assesses women 65–85 years of age who suffered a fracture and
who had either a bone mineral density test or a prescription for
a drug to treat osteoporosis in the six months after the fracture.
Persistence of Beta Blocker treatment after a Heart Attack
(BPH):
Assesses adults 18 years of age and older during the
measurement year who were hospitalized and discharged alive
with a diagnosis of acute myocardial infarction and who
received persistent beta-blocker treatment for six months after
discharge.
Smoking Cessation:

6. Assesses current smokers seen by a physician during the year
who were advised to quit, and cessation medications were
recommended and discussed. Different cessation methods were
discussed
.
Weight Assessment:
Assessed patients between the ages of 3 to 17 who had been
examined for body mass index (BMI, received counseling on
nutrition). Counseling or referral for physical activity or
indication physical activity was addressed during an outpatient
visit either by a claim or as a medical record entry during the
measurement year.
Assesses the percentage of members 18–74 years of age who
had an outpatient visit and whose body mass index (BMI) was
documented during the measurement year or the year prior to
the measurement year.
Guided Response:
Choose two classmates’ posts, and respond to the questions
listed below. Your guided response posts should be a minimum
of five well-developed sentences.
Do you agree or disagree with their choice of CQI Model given
the measures they chose?
Give rationale why you either agree or disagree, and give one
example that illustrates your answer.