1. Medication Dispensed vs. Ordered Change Review Process Meeting November 19, 2015 Jenna Williams-Bader Anne Marie Smith Stephanie Rodriguez

2. 2 Summary of Issue JIRA issue and discussed during governance call Affects the following measures: –Use of Appropriate Medications for Asthma (CMS126) –Follow-Up Care for Children Prescribed Attention Deficit/Hyperactivity Disorder (ADHD) Medication (CMS136) –Anti-depressant Medication Management (CMS128) Pros of using “dispensed”Cons of using “dispensed” Encourages interoperabilityStakeholders say dispensing information is not available to most providers Aligns more closely with the measure intent

3. 3 Feedback on Options October CRP discussion –Measures stay as dispensed: 9/19 –Measures changed to ordered: 3/19 –Stratified option (first look for “dispensed”, and if not available, then look for “ordered”): 7/19 Public comment –5 Comments –Overall support to change to “medication, ordered” until standards evolve and data becomes more widely available

4. 4 Additional Feedback from NCQA NCQA does not recommend stratifying results as it does not reflect measure intent NCQA recommends keeping “medication, dispensed” for two measures because it aligns with the measure intent –Follow-Up Care for Children Prescribed Attention Deficit/Hyperactivity Disorder (ADHD) Medication (CMS136) –Anti-depressant Medication Management (CMS128) For Use of Appropriate Medications for Asthma (CMS126), NCQA recommends changing the measure to “medication, ordered” –Recommend retiring measure

5. 5 Next Steps: Vote 1.Keep CMS136 and CMS128 as “medication, dispensed” and change CMS126 to “medication, ordered” 2.Keep all measures as “medication, dispensed” 3.Change all measures to “medication, ordered”