Module 3 · Provider Performance · 3.8
Quality Measure Operations The operational backbone for the quality measures themselves — the specifications, validation rules, versioning, lifecycle, and reliability standards underpinning every provider score.
Active Measure Inventory Dimension Status Sort Cross-measure correlation → Measure Dim Steward Ver Contracts Network Complete Reliability Status D1-001 HbA1c Control (< 8%) D1 ICHOM v3.1 6 74.2 97% OK Active D1-002 LDL Control (statin therapy) review due D1 NCQA v2.4 3 72.5 89% OK Under review D1-003 Blood Pressure Control (< 140/90) review due D1 NCQA v2.4 5 79.1 96% OK Active D1-004 Retinopathy Screening D1 ICHOM v3.1 4 71.8 88% OK Active D10-01 Data Quality Score D10 AiQL v1.4 9 84.6 99% OK Active D2-001 EQ-5D PROMs Collection Rate data issue D2 ICHOM v2.0 7 63.8 79% OK Active D2-002 PHQ-9 Response Capture D2 APA v1.9 3 61.2 74% Low denominator Active D3-01 PREM Satisfaction (top-box) D3 AiQL v1.2 8 78 82% OK Active D4-009 Sepsis Bundle Compliance data issue D4 CMS v0.3 0 — — Data quality Development D4-01 Medication Reconciliation D4 NCQA v2.1 6 90.1 94% OK Active D4-02 Adverse Drug Events / 1,000 review due D4 CMS v1.6 5 5.2 91% OK Active D5-001 ADA Guideline Adherence D5 AiQL v2.2 4 80.2 93% OK Active D5-011 Legacy Foot-Exam Rate D5 ADA v1.0 0 77 84% OK Retired D6-003 Telehealth Slot Availability D6 AiQL v1.0 2 19.4 80% OK Active D6-01 Third-Next-Available (days) D6 AiQL v1.0 3 8.4 86% OK Active D7-004 Care Continuity Index D7 AiQL v0.9 0 — 61% Low denominator Shadow D8-01 Diabetic Retinal Screening Uptake D8 NCQA v2.0 4 68.9 90% OK Active D9-003 Equity-Adjusted Access Gap data issue D9 AiQL v0.7 0 — 55% Low denominator Shadow M-BPCE BPC-E — Blood Pressure Control PHTI HEDIS / PHTI v1.0 1 57.3 92% OK Active M-HBA1C HbA1c Reduction ≥ 1.0 pt PHTI Custom / PHTI v1.0 1 60.1 92% OK Active M-MCID MCID on Validated MSK Scale PHTI Custom / PHTI v1.0 1 56.3 89% Low denominator Active M-PHQ9 PHQ-9 Improvement PHTI APA / PHTI v1.0 1 57.3 90% OK Active
