1. Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic Updates (CMS164) Change Review Process Meeting November 19, 2015 Jenna Williams-Bader Anne Marie Smith Stephanie Rodriguez

2. 2 IVD: Use of Aspirin or Another Antithrombotic Measure Update Revise measure to align with the HEDIS provider- level measure Measure Title: Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet Denominator: Patients 18 years of age and older with a visit during the measurement period who had an AMI, CABG, or PCI during the 12 months prior to the measurement year or who had a diagnosis of IVD during the measurement year (removed “discharged alive” language) Numerator: Update value set name to “Aspirin and Other Antiplatelets” Exclude patients who had documentation of use of anticoagulant medications during the measurement year

3. 3 Current Denominator Measure intent is to capture appropriate aspirin or other antiplatelet use in adults diagnosed with certain heart conditions Denominator Statement Patients 18 years of age and older with a visit during the measurement period, and an active diagnosis of ischemic vascular disease (IVD) or who were discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period

4. 4 Updated Denominator Denominator Statement Patients 18 years of age and older with a visit during the measurement period who were discharged alive who had an AMI, CABG, or PCI during the 12 months prior to the measurement year or who had a diagnosis of IVD during the measurement year The updated measure denominator removes the “discharged alive” language

5. 5 New Exclusion Patients who had documentation of use of anticoagulant medications during the measurement year – AND: "Medication, Active: Anticoagulant Medication" overlaps "Measurement Period"

6. 6 Next Steps: Vote Agree with proposed changes to Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic measure (CMS164)? 1.Yes 2.No Measure updates will be implemented during 2016 Annual Update