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Quality Measures by Topic
Adult Medicaid Dental
Care Management Program
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Acute and Chronic Care
Behavioral Health Care
Children
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Design Your Own Report
Step 1: Select your measure(s).
Filter Measures by One or More Topics
Include uncategorized
Access to Care and Treatment
Appropriate & Effective Dental Care
Behavioral Health Care
Behavioral Health Care - Adults
Behavioral Health Care - Children
Behavioral Health Care - Older Adults
Behavioral Health Care - Special Needs Population
Beneficiary Demographics - Standard Medicaid
Cardiovascular Health Care - Adults
Care Coordination
Care Coordination - Children
Care Management
CMS Medicaid Adult Core Set - NH Health Protection Program
CMS Medicaid Adult Core Set - Standard Medicaid
CMS Medicaid Child Core Set
Dental Organization Operations
Dental Provider Network Management
Diabetes Health Care - Adults
Grievances and Appeals
Health Services Management - Standard Medicaid
HEDIS Acute and Chronic Care Measures
HEDIS Behavioral Health Care Measures
HEDIS Preventive Care Measures
Hospital Inpatient and Outpatient Care
Hospital Inpatient and Outpatient Care - Adults
Hospital Inpatient and Outpatient Care - Children
Hospital Inpatient and Outpatient Care - NH Health Protection Program Members
Hospital Inpatient and Outpatient Care - Older Adults
Hospital Inpatient and Outpatient Care - Special Needs Population
Immunizations - Children
Long Term Community Based Care
Long Term Community Based Care - Adults
Long Term Community Based Care - Children
Member Experience of Care - Adults
Member Experience of Care - Children
Member Services
Network Adequacy
Non-Emergent Medical Transportation (NEMT)
Office and Clinic Care
Office and Clinic Care - Adults
Office and Clinic Care - Children
Office and Clinic Care - NH Health Protection Program Members
Office and Clinic Care - Older Adults
Office and Clinic Care - Special Needs Population
Pharmacy
Pharmacy - Adults
Pharmacy - Children
Pharmacy - Older Adults
Provider Network Management
Provider Services
Respiratory Health Care
Respiratory Health Care - Adults
Respiratory Health Care - Children
Screenings - Adults
Screenings - Children
Substance Use Disorder Care
Substance Use Disorder Care - NH Health Protection Program Members
Well Care - Children
Measures
*
Access to Preventive/ Ambulatory Health Services for Adult Medicaid Members with SMI
Access to Preventive/ Ambulatory Health Services for Adult Medicaid Members with SUD in a Calendar Year
Access to Preventive/ Ambulatory Health Services for Adult Medicaid Members with SUD in a Calendar Year by Subpopulation
Access to Preventive/ Ambulatory Health Services for Adult Medicaid Members with SUD by Subpopulation: Adults
Not Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Access to Preventive/ Ambulatory Health Services for Adult Medicaid Members with SUD by Subpopulation: Children
Not Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Access to Preventive/ Ambulatory Health Services for Adult Medicaid Members with SUD by Subpopulation: Older Adult
Not Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)
Adherence to Non-Infused Biologic Medications Used to Treat Rheumatoid Arthritis (PDC-RA)
Adolescent Well-Care Visits (AWC)
Adult BMI Assessment (ABA)
Adult Immunization Status (AIS-E): Influenza
Adult Immunization Status (AIS-E): Influenza
A. Age 19-65 Years
Adult Immunization Status (AIS-E): Influenza
Adult Immunization Status (AIS-E): Td/Tdap
Adult Immunization Status (AIS-E): Td/Tdap
Adult Immunization Status (AIS-E): Td/Tdap
A. Age 19-65 Years
Adult Immunization Status (AIS-E): Zoster
Adult Immunization Status (AIS-E): Zoster
A. Age 19-65 Years
Adult Immunization Status (AIS-E): Zoster
Adults' Access to Preventive/Ambulatory Health Services (AAP)
A: Age 20-44 Years
B: Age 45-64 Years
C. Age 65+ Years
Ambulatory Care (AMB) - Total Medicaid Emergency Department Visits
A. Age <1
B. Age 1-9 Years
C. Age 10-19 Years
D. Age 20-44 Years
E. Age 45-64 Years
F. Age 65-74 Years
G. Age 75-84 Years
H. Age 85+ Years
I. Age Unknown
Ambulatory Care (AMB) - Total Medicaid Outpatient Visits
A. Age <1
B. Age 1-9 Years
C. Age 10-19 Years
D. Age 20-44 Years
E. Age 45-64 Years
F. Age 65-74 Years
G. Age 75-84 Years
H. Age 85+ Years
I. Age Unknown
Antibiotic Utilization for Respiratory Conditions (AXR)
A: Age 3 Months -17 Years
B: Age 18-64 Years
C. Age 65+ Years
Antidepressant Medication Management (AMM): Effective Acute Phase Treatment
Antidepressant Medication Management (AMM): Effective Continuation Phase Treatment
Appropriate Testing for Children With Pharyngitis (CWP)
Appropriate Testing for Pharyngitis (CWP)
A. Age 3-17 Years
B. Age 18-64 Years
C. Age 65+ Years
Appropriate Treatment for Upper Respiratory Infection (URI)
A. Age 3 Months-17 Years
B. Age 18-64 Years
C. Age 65 and Older
Asthma Medication Ratio (AMR)
A. Age 5 to 11 Years
B. Age 12 to 18 Years
C. Age 19 to 50 Years
D. Age 51 to 64 Years
Asthma in Younger Adults Admission Rate (PQI15, CMS Adult Core Set)
Average Pharmacy Claim Processing Time
Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB)
A. Age 3 Months - 17 Years
B. Age 18 - 64 Years
C. Age 65 and Older
Best Effort to Have New Member Complete MCO's Health Risk Assessment Screening: B: Not Completed - Member Refused
Best Effort to Have New Member Complete MCO's Health Risk Assessment Screening: C: Not Completed - Member Did Not Refuse and MCO Made at Least 3 Attempts
Blood Pressure Control for Patients With Diabetes (BPD)
Breast Cancer Screening (BCS)
Breast Cancer Screening (BCS)
Cardiac Rehabilitation - Achievement (CRE)
Cardiac Rehabilitation - Achievement (CRE): A. Age 18-64 Years
Cardiac Rehabilitation - Achievement (CRE): A. Age 65UP Years
Cardiac Rehabilitation - Engagement 2 (CRE)
Cardiac Rehabilitation - Engagement 2 (CRE): A. Age 18-64 Years
Cardiac Rehabilitation - Engagement 2 (CRE): A. Age 65UP Years
Cardiac Rehabilitation - Engagement 1 (CRE)
A. Age 18-64 Years
A. Age 65UP Years
Cardiac Rehabilitation - Initiation (CRE)
A. Age 18-64 Years
Cardiac Rehabilitation - Initiation (CRE): A. Age 65UP Years
Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC)
Care Management Comprehensive Assessment Attempts Completed within 30 Days
A. Completed
D. Not Completed - Member Did Not Refuse & Attempts Not Completed
Care Management Comprehensive Assessment Attempts Completed within 30 Days: B: Not Complete - Member Refused
Care Management Comprehensive Assessment Attempts Completed within 30 Days: C: Not Complete - Member Did Not Refuse & Attempts Completed
Care Management Comprehensive Assessment Results within 14 Calendar Days
Care Management Outreach to High-Risk/High-Need Members
A. Enrolled
B. Not Enrolled - Member Refused
Care Management Outreach to High-Risk/High-Need Members: C: Not Enrolled - Member Did Not Refuse & Attempts Completed
Care Management Outreach to High-Risk/High-Need Members: D: Not Enrolled- Member Did Not Refuse & Attempts Not Completed
Cervical Cancer Screening (CCS)
Child and Adolescent Well-Care Visits (WCV)
A: Age 3-11 Years
B: Age 12 - 17 Years
C. Age 18-21 Years
Childhood Immunization Status (CIS): Combination 10
Childhood Immunization Status (CIS): Combination 3
Childhood Immunization Status (CIS): Combination 7
Children and Adolescents' Access to Primary Care Practitioners (CAP): A. Age 12-24 Months
Children and Adolescents' Access to Primary Care Practitioners (CAP): B. Age 25 Months - 6 Years
Children and Adolescents' Access to Primary Care Practitioners (CAP): C. Age 7-11 Years
Children and Adolescents' Access to Primary Care Practitioners (CAP): D. Age 12-19 Years
Children with Chronic Conditions: Child Limited or Prevented in Ability to do Things Most Children of Same Age Can Do (CAHPS® - Child)
Children with Chronic Conditions: Child Needs/Gets Special Therapy (e.g., Physical, Occupational, or Speech) (CAHPS® - Child)
Children with Chronic Conditions: Child Needs/Uses More Health Care than Usual for Children of Same Age (CAHPS® - Child)
Children with Chronic Conditions: Child Needs/Uses Prescribed Medicine Due Health Condition (CAHPS® - Child)
Children with Chronic Conditions: Child has Emotional, Developmental, or Behavioral Problem for which They Need/Get Treatment or Counseling (CAHPS® - Child)
Chlamydia Screening in Women (CHL)
A. Age 16-20 Years
B. Age 21-24 Years
Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate (PQI05, CMS Adult Core Set)
A. Age 40-64 Years
B. Age 65 and Older
Claims Quality Assurance: Claims Financial Accuracy
Claims Quality Assurance: Claims Payment Accuracy
Claims Quality Assurance: Claims Processing Accuracy
Colorectal Cancer Screening (COL)
A. Age 46-50 Years
B. Age 51-75 Years
Colorectal Cancer Screening (COL, CMS Adult Core Set)
A. Age 46-50 Years
B. Age 51-65 Years
C. Age 66-75 Years
Community Hospital Discharges for Mental Health-Related Conditions - Follow-up Visit within 30 Days of Discharge
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Prim
Medicare Prim
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Pr
Medicare Pr
Other Prima
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Community Hospital Discharges for Mental Health-Related Conditions - Follow-up Visit within 7 Days of Discharge
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Prima
Medicare Prima
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Pri
Medicare Pri
Other Primar
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Community Hospital Readmissions for Mental Health-Related Conditions within 180 Days of Discharge
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Community Hospital Readmissions for Mental Health-Related Conditions within 30 Days of Discharge
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Community Hospital or APRT Readmissions for Mental Health Conditions at 180 Days
Community Hospital or APRT Readmissions for Mental Health Conditions at 180 days: Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Community Hospital or APRT Readmissions for Mental Health Conditions at 180 days: Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Community Hospital or APRT Readmissions for Mental Health Conditions at 180 days: Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Community Hospital or APRT Readmissions for Mental Health Conditions at 30 Days
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Comprehensive Diabetes Care (CDC): Blood Pressure Control (<140/90 mm Hg)
Comprehensive Diabetes Care (CDC): Eye Exam
Comprehensive Diabetes Care (CDC): HbA1c Control (<8.0%)
Comprehensive Diabetes Care (CDC): HbA1c Poor Control (>9.0%)
Comprehensive Diabetes Care (CDC): HbA1c Testing
Comprehensive Diabetes Care (CDC, Hybrid Specification): Medical Attention for Nephropathy
Concurrent Use of Opioids and Benzodiazepines (CUOB, CMS Adult Core Set)
A. Age 18 to 64 Years
B. Age 65 and Older
Contraceptive Care – All Women - Most Effective or Moderately Effective Contraception (CCW, CMS Adult and Child Core Set)
A. Age 15 to 20 Years
B. Age 21 to 44 Years
Contraceptive Care – All Women : Long-Acting Reversible Method of Contraception (LARC) (CCW, CMS Adult and Child Core Set)
A. Age 15 to 20 Years
B. Age 21 to 44 Years
Contraceptive Care – Postpartum Women: Long-Acting Reversible Method of Contraception (LARC) – 3 days (CCP, CMS Adult and Child Core Sets)
A. Age 15–20
B. Age 21–44
Contraceptive Care – Postpartum Women: Long-Acting Reversible Method of Contraception (LARC) – 90 days (CCP, CMS Adult and Child Core Sets)
A. Age 15–20
B. Age 21–44
Contraceptive Care – Postpartum Women: Most or Moderately Effective Contraception – 3 Days by Age Group (CCP, CMS Adult and Child Core Sets)
A. Age 15–20
B. Age 21–44
Contraceptive Care – Postpartum Women: Most or Moderately Effective Contraception – 90 days by Age Group (CCP, CMS Adult and Child Core Sets)
A. Age 15–20
B. Age 21–44
Controlling High Blood Pressure (CBP)
Dental Claims Quality Assurance: Dental Claims Financial Accuracy
A. Diagnostic
B. Preventive
C. Restorative
D. Prosthodontics, Removable
E. Oral & Maxillofacial Surgery
F. Adjunctive
G. Periodontics
H. Maxillofacial Prosthetics
I. Implant Services
Dental Claims Quality Assurance: Dental Claims Payment Accuracy
A. Diagnostic
B. Preventive
C. Restorative
D. Prosthodontics, Removable
E. Oral & Maxillofacial Surgery
F. Adjunctive
G. Periodontics
H. Maxillofacial Prosthetics
I. Implant Services
Dental Claims Quality Assurance: Dental Claims Processing Accuracy
A. Diagnostic
B. Preventive
C. Restorative
D. Prosthodontics, Removable
E. Oral & Maxillofacial Surgery
F. Adjunctive
G. Periodontics
H. Maxillofacial Prosthetics
I. Implant Services
Dental Member Communications: Calls Abandoned
Dental Member Communications: Speed to Answer Within 30 Seconds
Dental Member Communications: Calls Returned by the Next Business Day
Dental Member Communications: Reasons for Telephone Inquiries
A. Benefit Question
B. Billing Issues
C. Finding/Changing a Dentist
D. Finding a Specialist (e.g., Oral Surgeon)
E. Complaints About Dental Organization
F. Enrollment Status
G. Material/Publication Request
H. Information/Demographic Update
I. Incentives
J. NEMT Inquiry
K. Other
Dental Provider Communications: Calls Abandoned
Dental Provider Communications: Speed to Answer within 30 Seconds
Dental Provider Communications: Calls Returned by Next Business Day
Dental Provider Communications: Reasons for Telephone Inquiries
A. Verifying Member Eligibility
B. Billing/Payment
C. Service Authorization
D. Change of Address, Name, Contact Info., etc.
E. Enrollment/Credentialing
F. Complaints about Dental Organization
G. Other
Dental Service, Equipment and Supply Service Authorization Timely Determination Rate: Urgent Requests
Dental Service, Equipment and Supply Service Authorization Timely Determination Rate: New Routine Requests
Dental Service, Equipment and Supply Service Authorization Timely Determination Rate: Post-Delivery Requests
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) - Depression Screening
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) - Screening: Age 12-17 Years
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) - Screening: Age 18-64 Years
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) - Screening: Age 65 Years and Over
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E): Follow-Up
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) - Follow-Up: Age 12-17 Years
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) - Follow-Up: Age 18-64 Years
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) - Follow-Up: Age 65 Years and Over
Developmental Screening in the First Three Years of Life (DEV, CMS Child Core Set)
A. Children who turned 1 year of age
B. Children who turned 2 years of age
C. Children who turned 3 years of age
Developmental Screening in the First Three Years of Life (DEV, CMS Child Core Set)
A. Children Who Turned 1 year of Age During the Measurement Period
B. Children Who Turned 2 Years of Age During the Measurement Period
C. Children Who Turned 3 Years of Age During the Measurement Period
Diabetes Care for People with Serious Mental Illness - HA1c Testing Poor Control (>9%) (HPCMI, CMS Adult Core Set)
A. Age 18-64 Years
B. Age 65-75 Years
Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD)
Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD)
Diabetes Short-Term Complications Admission Rate (PQI01,CMS Adult Core Set)
A. Age 18-64 Years
B. Age 65 and Older
Diagnosed Mental Health Disorders (DMH-E)
A. Age 1-17 Years
B. Age 18-64 Years
C. Age 65 and Over
Diagnosed Substance Use Disorders (DSU) - Alcohol
A. Age 13-17 Years
B. 18-64 Years
C. Age 65 and Older
Diagnosed Substance Use Disorders (DSU) - Any Substance
A. Age 13-17 Years
B. 18-64 Years
C. Age 65 and Older
Diagnosed Substance Use Disorders (DSU) - Opioid
A. Age 13-17 Years
B. 18-64 Years
C. Age 65 and Older
Diagnosed Substance Use Disorders (DSU) - Other or Unspecified Drugs.
Diagnosed Substance Use Disorders (DSU) - Other or Unspecified Drugs: A. Age 13-17 Years
Diagnosed Substance Use Disorders (DSU) - Other or Unspecified Drugs: B. 18-64 Years
Diagnosed Substance Use Disorders (DSU) - Other or Unspecified drugs disorder: C. Age 65 and Older
ED Visits for Mental Health Preceded by NH Hospital Stay in Past 30 Days
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Engagement of Substance Use Disorder Treatment (IET) - Alcohol
A. Age 13-17 Years
B. Age 18-64 Years
C. Age 65 and Older
Engagement of Substance Use Disorder Treatment (IET) - Opioid
A. Age 13-17 Years
B. Age 18-64 Years
C. Age 65 and Older
Engagement of Substance Use Disorder Treatment (IET) - Other Substance Use
A. Age 13-17 Years
B. Age 18-64 Years
C. Age 65 and Older
Engagement of Substance Use Disorder Treatment (IET) - Total (Alcohol, Opioid and Other Substance Use)
A. Age 13-17 Years
B. Age 18-64 Years
C. Age 65 and Older
Eye Exam for Patients With Diabetes (EED)
Family and Friends Program NEMT Legs
Family and Friends Program NEMT Legs for Adult Dental Services
Flu Vaccinations for Adults Ages 18 - 64 (FVA) (CAHPS® - Adult)
Follow-Up After Emergency Department Visit for Substance Use (FUA) within 07 days
A. Age 13 to 17 Years.
B. Age 18+ Years
Follow-Up After Emergency Department Visit for Substance Use (FUA) within 30 days
A. Age 13 - 17 Years
B. Age 18+ Years
Follow-Up After Hospitalization for Mental Illness (FUH) Within 07 Days
Follow-Up After Hospitalization for Mental Illness (FUH) within 07 Days by Age
A. 6 - 17 Years
B. 18 - 64 Years
C. 65 Years and Older
Follow-Up After Hospitalization for Mental Illness (FUH) within 30 Days
Follow-Up After Hospitalization for Mental Illness (FUH) within 30 Days by Age
A. 6 - 17 Years
B. 18 - 64 Years
C. 65 Years and Older
Follow-Up Care for Adult Medicaid Beneficiaries Who are Newly Prescribed an Antipsychotic Medication
Follow-Up Care for Children Prescribed ADHD Medication (ADD): Continuation and Maintenance Phase
Follow-Up Care for Children Prescribed ADHD Medication (ADD): Initiation Phase
Follow-Up after High-Intensity Care for Substance Use Disorder (FUI) within 07 Days
A. 13-17 Years
B. 18-64 Years
C. 65 Years and Older
Follow-Up after High-Intensity Care for Substance Use Disorder (FUI) within 30 Days
A. 13-17 Years
B. 18-64 Years
C. 65 Years and Older
Follow-up After Emergency Department Visit for Mental Illness (FUM) Within 30 days by Age
A. 6 - 17 Years
B. 18 - 64 Years
C. 65 Years and Older
Follow-up After Emergency Department Visit for Mental Illness (FUM) Within 7 days by Age
A. 6 - 17 Years
B. 18 - 64 Years
C. 65 Years and Older
Follow-up after Emergency Department Visit for Mental Illness (FUM) within 07 Days
Follow-up after Emergency Department Visit for Mental Illness (FUM) within 30 Days
Getting Care Quickly: Days to Get Appointment For Check-up or Routine Care (CAHPS® - Adult)
A. Same Day
B. 1 Day
C. 2 to 3 Days
D. 4 to 7 Days
E. 8 to 14 Days
F. 15 to 30 Days
G. More than 30 Days
Getting Care Quickly: Days to Get Appointment For Check-up or Routine Care (CAHPS® - Child)
A. Same Day
B. 1 Day
C. 2 to 3 Days
D. 4 to 7 Days
E. 8 to 14 Days
F. 15 to 30 Days
G. More than 30 Days
Getting Care Quickly: Days to Get Appointment When Care Needed Right Away (CAHPS® - Adult)
A. Same Day
B. 1 Day
C. 2 - 3 Days
D. 4 - 7 Days
E. More than 7 Days
Getting Care Quickly: Days to Get Appointment When Care Needed Right Away (CAHPS® - Child)
A. Same Day
B. 1 Day
C. 2 - 3 Days
D. 4 - 7 Days
E. More than 7 Days
Getting Care Quickly: Getting Appointment with Specialist as Soon as Needed - Usually or Always (CAHPS® - Adult)
Getting Care Quickly: Getting Appointment with Specialist as Soon as Needed - Usually or Always (CAHPS® - Child)
Getting Care Quickly: Getting Needed Care Right Away - Usually or Always (CAHPS® - Adult)
Getting Care Quickly: Getting Needed Care Right Away - Usually or Always (CAHPS® - Child)
Getting Care Quickly: Getting Needed Care from a Doctor's Office or Clinic During Evenings, Weekends, or Holidays - Usually or Always (CAHPS® - Adult)
Getting Care Quickly: Getting Needed Care from a Doctor's Office or Clinic During Evenings, Weekends, or Holidays - Usually or Always (CAHPS® - Child)
Getting Care Quickly: Getting Routine or Check-up Appointments as Soon as They Were Needed - Usually or Always (CAHPS® - Adult)
Getting Care Quickly: Getting Routine or Check-up Appointments as Soon as They Were Needed - Usually or Always (CAHPS® - Child)
Getting Needed Care: Care Coordination for More than One Kind of Health Care Provider or Service (CAHPS® - Child)
Getting Needed Care: Ease In Getting Care, Tests, and Treatment - Usually or Always (CAHPS® - Adult)
Getting Needed Care: Ease In Getting Care, Tests, and Treatment - Usually or Always (CAHPS® - Child)
Getting Needed Care: Ease in Getting Prescription Medicines - Usually or Always (CAHPS® - Child)
Getting Needed Care: Ease in Getting Special Medical Equipment or Devices for Child - Usually or Always (CAHPS® - Child)
Getting Needed Care: Ease in Getting Special Therapy for their Child - Usually or Always (CAHPS® - Child)
Getting Needed Care: Ease in Getting Treatment or Counseling for an Emotional, Developmental, or Behavioral Problem - Usually or Always (CAHPS® - Child)
Getting Needed Care: Getting Questions Answered by Doctors or Other Health Providers - Usually or Always (CAHPS® - Child)
Getting Needed Care: Got Care from a Doctor or Other Health Provider Besides Their Personal Doctor (CAHPS® - Adult)
Getting Needed Care: Got Care from a Doctor or Other Health Provider Besides Their Personal Doctor (CAHPS® - Child)
Getting Needed Care: Got Help Needed From Child's Doctors or Other Health Providers to Contact Child's School or Daycare (CAHPS® - Child)
Getting Needed Care: Health Plan, Doctor's Office, or Clinic Helped Get Prescription Medicines (CAHPS® - Child)
Getting Needed Care: Health Plan, Doctor's Office, or Clinic Helped Get Special Medical Equipment or Devices (CAHPS® - Child)
Getting Needed Care: Health Plan, Doctor's Office, or Clinic Helped Get Special Therapy (CAHPS® - Child)
Getting Needed Care: Health Plan, Doctor's Office, or Clinic Helped Get Treatment or Counseling for an Emotional, Developmental, or Behavioral Problem (CAHPS® - Child)
Getting Needed Care: Needed Child's Doctors or Other Health Providers to Contact Child's School or Daycare (CAHPS® - Child)
Getting Needed Care: Telehealth Visits as Helpful as In-Person Visit (CAHPS® - Adult)
A. Yes, Definitely
B. Yes, Somewhat
C. No
Getting Needed Care: Telehealth Visits as Helpful as In-Person Visit (CAHPS® - Child)
A. Yes, Definitely
B. Yes, Somewhat
C. No
Health Plan Complaint Process Awareness (CAHPS® - Adult)
Health Plan Complaint Process Awareness (CAHPS® - Child)
Health Plan Customer Service Provided Information or Help - Usually or Always (CAHPS® - Adult)
Health Plan Customer Service Provided Information or Help - Usually or Always (CAHPS® - Child)
Health Plan Customer Service Treated Caregiver with Courtesy and Respect - Usually or Always (CAHPS® - Child)
Health Plan Customer Service Treated Member with Courtesy and Respect - Member's Health Plan- Usually or Always (CAHPS® - Adult)
Heart Failure Admission Rate (PQI08, CMS Adult Core Set)
A. Age 18-64 Years
B. Age 65 and Older
Hemoglobin A1c Control for Patients With Diabetes - HbA1c Control (<8.0%)
A. Age 18-64 Years
B. Age 65-75 Years
Hemoglobin A1c Control for Patients With Diabetes - HbA1c Poor Control (>9.0%)
A. Age 18-64 Years
B. Age 65-75 Years
Hemoglobin A1c Control for Patients with Diabetes: HbA1c Control (<8.0%) (HBD)
Hemoglobin A1c Control for Patients with Diabetes: HbA1c Poor Control (>9.0%) (HBD)
How Well Doctors Communicate: Child Able to Talk with Doctors about His or Her Health Care (CAHPS® - Child)
How Well Doctors Communicate: Feel Comfortable Speaking To Doctor or Other Health Provider About Personal or Family Problems with Alcohol or Other Drugs (CAHPS® - Adult)
How Well Doctors Communicate: Personal Doctor Asked About Feeling Sad, Empty, or Depressed (CAHPS® - Adult)
How Well Doctors Communicate: Personal Doctor Explained Things - Usually or Always (CAHPS® - Child)
How Well Doctors Communicate: Personal Doctor Explained Things in Way Easy to Understand - Usually or Always (CAHPS® - Adult)
How Well Doctors Communicate: Personal Doctor Explained Things in a Way Easy for Child to Understand - Usually or Always (CAHPS® - Child)
How Well Doctors Communicate: Personal Doctor Listened Carefully - Usually or Always (CAHPS® - Adult)
How Well Doctors Communicate: Personal Doctor Listened Carefully - Usually or Always (CAHPS® - Child)
How Well Doctors Communicate: Personal Doctor Showed Respect - Usually or Always (CAHPS® - Adult)
How Well Doctors Communicate: Personal Doctor Showed Respect - Usually or Always (CAHPS® - Child)
How Well Doctors Communicate: Personal Doctor Spent Enough Time with Child - Usually or Always (CAHPS® - Child)
How Well Doctors Communicate: Personal Doctor Spent Enough Time with Member - Usually or Always (CAHPS® - Adult)
How Well Doctors Communicate: Personal Doctor Talked with Caregiver about How Child is Feeling, Growing, or Behaving (CAHPS® - Child)
How Well Doctors Communicate: Personal Doctor Understands How Health Conditions Affect Child's Day-to-Day Life (CAHPS® - Child)
How Well Doctors Communicate: Personal Doctor Understands How Health Conditions Affect Child's Family's Day-to-Day Life (CAHPS® - Child)
How Well Doctors Communicate: Personal Doctor Up-to-Date about Care from other Doctors or Health Providers - Usually or Always (CAHPS® - Adult)
How Well Doctors Communicate: Personal Doctor Up-to-Date about Care from other Doctors or Health Providers - Usually or Always (CAHPS® - Child)
How Well Doctors Communicate: Talked with Personal Doctor about Things in Life Causing Worry or Stress (CAHPS® - Adult)
A. Yes, Definitely
B. Yes, Somewhat
C. No
Immunizations for Adolescents (IMA): Combination 1
Immunizations for Adolescents (IMA): Combination 2
Immunizations for Adolescents (IMA): HPV
Immunizations for Adolescents (IMA): Meningococcal Vaccine
Immunizations for Adolescents (IMA): Tdap/Td Vaccine
Initiation of Substance Use Disorder Treatment (IET) - Alcohol
A. Age 13-17 Years
B. Age 18-64 Years
C. Age 65 and Older
Initiation of Substance Use Disorder Treatment (IET) - Opioid
A. Age 13-17 Years
B. Age 18-64 Years
C. Age 65 and Older
Initiation of Substance Use Disorder Treatment (IET) - Other Substance Use
A. Age 13-17 Years
B. Age 18-64 Years
C. Age 65 and Older
Initiation of Substance Use Disorder Treatment (IET) - Total (Alcohol, Opioid and Other Substance Use)
A. Age 13-17 Years
B. Age 18-64 Years
C. Age 65 and Older
Interest Paid on Late Paid Claims
Interest on Late Paid Dental Claims
Kidney Health Evaluation for Patients With Diabetes (KED)
A. Age 18-64 Years
B. Age 65-74 Years
C. 75-85
Lead Screening in Children (LSC)
MCO Contacts and Contact Attempts Following ED Discharges for SUD
Age 0 To 17 Years
Age 18 Years Or Older
Medical Assistance with Smoking and Tobacco Use Cessation: Advising Smokers and Tobacco Users to Quit (MSC, CMS Adult Core Set)
A. Age 18-64 Years
Medical Assistance with Smoking and Tobacco Use Cessation: Discussing Cessation Medications (MSC, CMS Adult Core Set)
A. Age 18-64 Years
Medical Assistance with Smoking and Tobacco Use Cessation: Discussing Cessation Strategies (MSC, CMS Adult Core Set)
A. Age 18-64 Years
Medical Service, Equipment and Supply Post-Delivery Service Authorization Timely Determination Rate
Medical Service, Equipment and Supply Service Authorization Timely Determination Rate: New Routine Requests
Medical Service, Equipment and Supply Service Authorization Timely Determination Rate: Urgent Requests
Medication Management for People With Asthma (MMA): Medication Compliance 50%
A. Age 5 to 11 Years
B. Age 12 to 18 Years
C. Age 19 to 50 Years
D. Age 51 to 64 Years
Medication Management for People With Asthma (MMA): Medication Compliance 75%
A. Age 5 to 11 Years
B. Age 12 to 18 Years
C. Age 19 to 50 Years
D. Age 51 to 64 Years
Member Appeals Received
Member Communications: Calls Abandoned
A. Main Health Plan
B. Pharmacy Benefit Manager (PBM)
C. Non-Emergent Medical Transportation (NEMT) Manager
D. Behavioral Health Manager
E. Vision Manager
Member Communications: Speed to Answer Within 30 Seconds
A. Main Health Plan
B. Pharmacy Benefit Manager (PBM)
C. Non-Emergent Medical Transportation (NEMT) Manager
D. Behavioral Health Manager
E. Vision Manager
Member Communications: Calls Returned by the Next Business Day
Member Communications: Reasons for Telephone Inquiries
A. Benefit Question Non-RX
B. Rx-Question
C. Billing Issue
D. Finding / Changing a PCP
E. Finding a Specialist
F. Complaints About Health Plan
G. Enrollment Status
H. Material Request
I. Information / Demographic Update
J. Giveaways
K. Other
L. NEMT Inquiry
Member Dental Appeals Received
Member Dental Grievances Received
Member Dental Services Authorized within 72 Hours Following a Reversed Appeal
Member Grievances Received
Member Non-Emergent Medical Transportation Grievance Dispositions Resolved Within 30 Calendar Days
Member Retention in SUD Treatment
Age 0 to 17 Years
Alcohol Use Disorder
Opioid Use Disorder
Other Drug Use Disorder
Stimulant Use Disorder
Age 18 Years or Older
Alcohol Use Disorder
Opioid Use Disorder
Other Drug Use Disorder
Stimulant Use Disorder
Members Enrolled in Care Management as of the Last Day of the Month
Members Enrolled in Care Management at Any Time During the Month
Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) - Blood Glucose Testing
Metabolic Monitoring for Adolescents on Antipsychotics (APM) - Blood Glucose Testing: B. Age 12-17 Years
A. Age 1-11 Years
Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) - Blood Glucose and Cholesterol Testing
A. Age 1-11 Years
B. Age 12-17 Years
Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) - Cholesterol Testing
A. Age 1-11 Years
B. Age 12-17 Years
NEMT Call Center - Abandoned Calls
NEMT Call Center - Calls Returned by Next Business Day
NEMT Call Center - Hold Status Less Than 4 Minutes
NEMT Call Center - Speed to Answer within 90 Seconds
NEMT Claims Quality Assurance: Claims Processing Accuracy
NEMT Legs Delivered by Covered Medical Service Provider Type
I. Medical or DME Supplier
NEMT Legs Delivered by Type of Covered Medical Service: A. Hospital
NEMT Legs Delivered by Type of Covered Medical Service: B. Medical Provider
NEMT Legs Delivered by Type of Covered Medical Service: C. Behavioral Health Provider
NEMT Legs Delivered by Type of Covered Medical Service: D. Dentist
NEMT Legs Delivered by Type of Covered Medical Service: E. Pharmacy
NEMT Legs Delivered by Type of Covered Medical Service: F. Methadone Treatment
NEMT Legs Delivered by Type of Covered Medical Service: G. Other
NEMT Legs Delivered by Type of Covered Medical Service: H. Dialysis
NEMT Request Authorization Approvals by Mode of Transportation
A. Contracted Transportation Provider (Non-Wheelchair Van)
B. Volunteer Driver
C. Member
D. Public Transportation
E. Wheelchair Van
F. Other
NEMT Scheduled Legs Assigned by Broker within Advanced Notice Period
NEMT Timely Claims Processing
NH Hospital Discharges - Discharge Plan Provided to Aftercare Provider within 7 Calendar Days of Member Discharge
NH Hospital Discharges - Follow-up Visit within 30 Days of Discharge
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
NH Hospital Discharges - Follow-up Visit within 7 Days of Discharge
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
NH Hospital Discharges - MCO Contacts and Contact Attempts
NH Hospital Discharges - Member Received Discharge Instruction Sheet
NH Hospital Discharges - New CMHC Patient Had Intake Appointment with CMHC within 7 Calendar Days of Discharge
Non-Recommended Cervical Cancer Screening in Adolescent Females (NCS)
Non-Surgical Ongoing Periodontal Care for Adults with Periodontitis by County
A. Belknap County
B. Carroll County
C. Cheshire County
D. Coos County
E. Grafton County
F. Hillsborough County
G. Merrimack County
H. Rockingham County
I. Strafford County
J. Sullivan County
K. Non-NH/Unknown
Number of Health Care Visits (CAHPS® - Adult)
A. None
B. One
C. Two
D. Three
E. Four
F. Five to Nine
G. Ten or More
Number of Health Care Visits (CAHPS® - Child)
A. None
B. One
C. Two
D. Three
E. Four
F. Five to Nine
G. Ten or More
Number of Specialists Child Talked To (CAHPS® - Child)
A. None
B. One
C. Two
D. Three
E. Four
F. Five or More Specialists
Number of Specialists Member Talked To (CAHPS® - Adult)
A. None
B. One
C. Two
D. Three
E. Four
F. Five or More
Number of Visits to Personal Doctor (CAHPS® - Adult)
A. None
B. One
C. Two
D. Three
E. Four
F. Five to Nine
G. Ten or More
Number of Visits with Personal Doctor (CAHPS® - Child)
A. None
B. One
C. Two
D. Three
E. Four
F. Five to Nine
G. Ten or More
Periodontal Evaluation in Adults with Periodontitis by County
A. Belknap County
B. Carroll County
C. Cheshire County
D. Coos County
E. Grafton County
F. Hillsborough County
G. Merrimack County
H. Rockingham County
I. Strafford County
J. Sullivan County
K. Non-NH/Unknown Counties
Persistence of Beta-Blocker Treatment After a Heart Attack (PBH)
Pharmacotherapy Management of COPD Exacerbation (PCE): Bronchodilator
Pharmacotherapy Management of COPD Exacerbation (PCE): Systemic Corticosteroid
Pharmacotherapy for Opioid Use Disorder (POD)
A. Age 16-64 Years
B. Age 65 and Older
Pharmacy Service Authorization Timely Determination Rate
Pharmacy Utilization Management: Generic Drug Substitution
Pharmacy Utilization Management: Generic Drug Utilization
Pharmacy Utilization Management: Generic Drug Utilization Adjusted for Preferred PDL Brands
Plan All-Cause Readmissions (PCR)
A. Age 18-44 Years
B. Age 45-54 Years
C. Age 55-64 Years
Polypharmacy Monitoring: Adults with 5 or More Prescriptions for 60 Consecutive Days
A. Age 18-44 Years
B. Age 45-64 Years
Polypharmacy Monitoring: Children with 4 or More Prescriptions for 60 Consecutive Days
A. Age 0-5 Years
B. Age 6-17 Years
Prenatal Immunization Status - Combination
Prenatal Immunization Status - Influenza
Prenatal Immunization Status - Tdap
Prenatal and Postpartum Care (PPC): Postpartum Care
Prenatal and Postpartum Care (PPC): Timeliness of Prenatal Care
Prescription Medication Usage: Personal Doctor Talked about All Taken - Usually or Always (CAHPS® - Adult)
Prescription Medications Usage: Personal Doctor Talked about All Taken - Usually or Always (CAHPS® - Child)
Private Duty Nursing: Authorized Hours for Adults Delivered and Billed by Quarter
A. Day/Evening Hours
B. Night/Weekend Hours
C. Intensive Care (Ventilator Dependent) Hours
D. Unbilled Hours
Private Duty Nursing: Authorized Hours for Children Delivered and Billed by Quarter
A. Day/Evening Hours
B. Night/Weekend Hours
C. Intensive Care (Ventilator Dependent) Hours
D. Unbilled Hours
Professional and Facility Medical Claim Processing Results
A. Paid
B. Suspended
C. Denied
Proportion of Days Covered (PDC) - Adherence to Direct-Acting Oral Anticoagulants (PDC-DOAC)
Proportion of Days Covered - Adherence to Long-Acting Inhaled Bronchodilator Agents in COPD Patients (PDC-COPD)
Proportion of Days Covered - Adherence to Non-Infused Disease Modifying Agents Used to Treat Multiple Sclerosis (PDC-MS)
Proportion of Days Covered - Antiretroviral Medications (PDC-ARV)
Proportion of Days Covered - Beta-Blockers (PDC-BB)
Proportion of Days Covered - Calcium Channel Blockers (PDC-CCB)
Proportion of Days Covered - Diabetes All Class Rate (PDC-DR)
Proportion of Days Covered - Renin Angiotensin System Antagonists (PDC-RASA)
Proportion of Days Covered - Statins (PDC-STA)
Proportion of Days Covered Composite (PDC-CMP)
Provider Communications: Calls Abandoned
A. Main Health Plan
B. Pharmacy Benefit Manager (PBM)
C. Non-Emergent Transportation (NEMT) Manager
D. Behavioral Health Manager
E. Vision Manager
Provider Communications: Speed to Answer within 30 Seconds
A. Main Health Plan
B. Pharmacy Benefit Manager (PBM)
C. Non-Emergent Transportation (NEMT) Manager
D. Behavioral Health Manager
E. Vision Manager
Provider Communications: Calls Returned by Next Business Day
Provider Communications: Reasons for Telephone Inquiries
A. Verifying Member Eligibility
B. Billing/Payment
C. Service Authorization
D. Change of Address, Name, Contact Info., etc.
E. Enrollment/Credentialing
F. Complaints about Health Plan
G. Other
Rating of Health Care - 8, 9 or 10 (CAHPS® - Adult)
Rating of Health Care - 8, 9 or 10 (CAHPS® - Child)
Rating of Health Plan - 8, 9, or 10 (CAHPS® - Adult)
Rating of Health Plan - 8, 9, or 10 (CAHPS® - Child)
Rating of Overall Health - Very Good or Excellent (CAHPS® - Adult)
Rating of Overall Health - Very Good or Excellent (CAHPS® - Child)
Rating of Overall Mental or Emotional Health - Very Good or Excellent (CAHPS® - Adult)
Rating of Overall Mental or Emotional Health - Very Good or Excellent (CAHPS® - Child)
Rating of Personal Doctor - 8, 9 or 10 (CAHPS® - Adult)
Rating of Personal Doctor - 8, 9 or 10 (CAHPS® - Child)
Rating of Specialist Child Talked to Most Often - 8, 9 or 10 (CAHPS® - Child)
Rating of Specialist Member Talked to Most Often - 8, 9 or 10 (CAHPS® - Adult)
Readmissions among Members with SUD
Readmissions among Members with SUD by Subpopulation
Adults
Not Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Children
Not Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Older Adult
Not Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Pregnant
Medicaid Primary
Medicare Primary
Other Primary
Readmissions for Mental Health Conditions within 30 Days
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Readmissions to NH Hospital within 180 Days
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Readmissions to NH Hospital within 30 Days
Adults
All Other Adults
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Special Needs Adult
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Children
Children With Severe Disabilities (HC-CSD, SSI, SMS)
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
DCYF Involved Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Other Special Needs Child
Not Receiving Waiver, CMHC, or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Older Adults
All Older Adults
Not Receiving Waiver, CMHC or Nursing Home Services
Medicaid Primary
Medicare Primary
Other Primary
Receiving CMHC Services But Not Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Receiving LTC Services-Waiver or Nursing Home
Medicaid Primary
Medicare Primary
Other Primary
Requests for Assistance Accessing Dentists by County
A. Belknap County
B. Carroll County
C. Cheshire County
D. Coos County
E. Grafton County
F. Hillsborough County
G. Merrimack County
H. Rockingham County
I. Strafford County
J. Sullivan County
K. Non-NH/Unknown Counties
Requests for Assistance Accessing MCO Designated Primary Care Providers by County
A. Belknap County
B. Carroll County
C. Cheshire County
D. Coos County
E. Grafton County
F. Hillsborough County
G. Merrimack County
H. Rockingham County
I. Strafford County
J. Sullivan County
K. Non-NH/Unknown Counties
Requests for Assistance Accessing Oral Surgeons by County
A. Belknap County
B. Carroll County
C. Cheshire County
D. Coos County
E. Grafton County
F. Hillsborough County
G. Merrimack County
H. Rockingham County
I. Strafford County
J. Sullivan County
K. Non-NH/Unknown Counties
Requests for Assistance Accessing non-MCO Designated Physician/APRN Specialists by County
A. Belknap County
B. Carroll County
C. Cheshire County
D. Coos County
E. Grafton County
F. Hillsborough County
G. Merrimack County
H. Rockingham County
I. Strafford County
J. Sullivan County
K. Non-NH/Unknown Counties
Resolution of All Appeals within 45 Calendar Days
Resolution of All Member Dental Appeals within 45 Calendar Days
Resolution of Appeals by Disposition Type
A. Member Abandoned Appeal
B. Appeal Upheld
C. Appeal Reversed
Resolution of Dental Provider Appeals within 30 Calendar Days
Resolution of Expedited Appeals within 72 Hours
Resolution of Expedited Member Dental Appeals within 72 Hours
Resolution of Extended Standard Appeals within 44 Calendar Days
Resolution of Extended Standard Member Dental Appeals within 45 Calendar Days
Resolution of Member Dental Appeals by Disposition Type
A. Member Abandoned Appeal
B. Appeal Upheld
C. Appeal Reversed
D. Appeal Partially Upheld
Resolution of Provider Appeals within 30 Calendar Days
Resolution of Standard Appeals within 30 Calendar Days
Resolution of Standard Member Dental Appeals within 30 Calendar Days
Results of Scheduled NEMT Legs by Outcome
A. Member Canceled or Rescheduled
B. Transportation Provider Canceled or Rescheduled
C. Member No Show
D. Transportation Provider No Show
E. Other Reason Leg Wasn't Made
F. Delivered
G. Unknown if Leg Occurred
H. Unable to Secure Transportation
I. Incorrect Mode of Transportation Dispatched
Results of Scheduled NEMT Legs for Adult Dental Services by Outcome
A. Member Canceled or Rescheduled
B. Transportation Provider Canceled or Rescheduled
C. Member No Show
D. Transportation Provider No Show
E. Other Reason Leg Wasn't Made
F. Delivered
G. Unknown if Leg Occurred
H. Unable to Secure Transportation
I. Incorrect Mode of Transportation Dispatched
Risk of Continued Opioid Use (COU) >= 15 Days by Age
A. Age 18 - 64 Years
B. 65+ Years
Risk of Continued Opioid Use (COU) >= 30 Days by Age
A. 18 - 64 Years
B. 65+ Years
Safety Monitoring - Opioid Prescriptions Meeting NH DHHS Morphine Equivalent Dosage Prior Authorization Compliance
Scheduled NEMT Legs Delivered On Time for Adult Dental Services
Screening for Depression and Follow-Up Plan (CDF, CMS Adult and Child Core Set)
A. Age 12 to 17 Years
B. Age 18 to 64 Years
C. Age 65 and Older
Service Authorization Denials for Waiver & Non-HCBC Waiver Populations
A. Non-HCBC Waiver
B. Developmentally Disabled (DD) Waiver
C. Acquired Brain Disorder (ABD) Waiver
D. In-Home Supports (IHS) Waiver
E. Choices for Independence (CFI) Waiver
Service Authorizations: Physical, Occupational & Speech Therapy Service Authorization Denials by Waiver & Non-HCBC Waiver Populations
A. Non-HCBC Waiver
B. Developmentally Disabled (DD) Waiver
C. Acquired Brain Disorder (ABD) Waiver
D. In-Home Supports (IHS) Waiver
E. Choices for Independence (CFI) Waiver
Services Authorized within 72 Hours Following a Reversed Appeal
Statin Therapy for Patients With Cardiovascular Disease (SPC): Received Statin Therapy
A. Males Age 21 to 75
B. Females Age 40 to 75
Statin Therapy for Patients With Cardiovascular Disease (SPC): Statin Adherence 80%
A. Males Age 21 to 75
B. Females Age 40 to 75
Statin Therapy for Patients With Diabetes (SPD): Received Statin Therapy
Statin Therapy for Patients With Diabetes (SPD): Statin Adherence 80%
Successful Completion of Dental Risk Assessment
Successful Completion of MCO Health Risk Assessment
Timeliness of Scheduled and Delivered FFS NEMT Legs
Timeliness of Scheduled and Delivered NEMT Legs
Timely Processing of All Clean Dental Claims: Ninety Days of Receipt
Timely Processing of All Clean Dental Claims: Thirty Days of Receipt
Timely Processing of All Clean Provider Claims: Ninety Days of Receipt
Timely Processing of All Clean Provider Claims: Thirty Days of Receipt
Timely Processing of All Member Dental Grievances
Timely Processing of Clean Electronic Provider Claims: Fifteen Days of Receipt
Timely Processing of Clean Non-Electronic Provider Claims: Thirty Days of Receipt
Timely Processing of Facility-to-Facility Transportation Claims: Thirty Days of Receipt
Timely Processing of Grievances
Timely Provider Credentialing - PCPs
Timely Provider Credentialing - Primary Dental Provider
Timely Provider Credentialing - Primary Dental Provider (Quarterly Reporting)
Timely Provider Credentialing - Specialty Dental Providers
Timely Provider Credentialing - Specialty Dental Providers (Quarterly Reporting)
Timely Provider Credentialing - Specialty Providers
Topical Fluoride for Adults at Elevated Caries Risk by County
A. Belknap County
B. Carroll County
C. Cheshire County
D. Coos County
E. Grafton County
F. Hillsborough County
G. Merrimack County
H. Rockingham County
I. Strafford County
J. Sullivan County
K. Non-NH/Unknown
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)
A. Age 1-11Years
C. Age 12-17 Years
Use of Imaging Studies for Low Back Pain (LBP)
Use of Imaging Studies for Low Back Pain (LBP) by Age
A. 18-64 Years
B. 65-75 Years
Use of Opioids at High Dosage (HDO)
Use of Opioids from Multiple Providers (UOP): Multiple Pharmacies
Use of Opioids from Multiple Providers (UOP): Multiple Prescribers
Use of Opioids from Multiple Providers (UOP): Multiple Prescribers and Multiple Pharmacies
Use of Pharmacotherapy for Opioid Use Disorder - Buprenorphine (OUD, CMS Adult Core Set)
Use of Pharmacotherapy for Opioid Use Disorder - Long-Acting, Injectable Naltrexone (OUD, CMS Adult Core Set)
Use of Pharmacotherapy for Opioid Use Disorder - Methadone (OUD, CMS Adult Core Set)
Use of Pharmacotherapy for Opioid Use Disorder - Oral Naltrexone (OUD, CMS Adult Core Set)
Use of Pharmacotherapy for Opioid Use Disorder - Total (OUD, CMS Adult Core Set)
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC, Hybrid Specification): Counseling for Nutrition
A. Age 3-11 Years
B. Age 12-17 Years
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC, Hybrid Specification): Counseling for Physical Activity
A. Age 3-11 Years
B. Age 12-17 Years
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC, Hybrid Specification): Evidence of BMI Percentile Documentation
A. Age 3-11 Years
B. Age 12-17 Years
Well-Child Visits in the First 15 Months of Life (W15): 6 or More Visits
Well-Child Visits in the First 30 Months of Life (W30) - Visits for Age 15 Months–30 Months
Well-Child Visits in the First 30 Months of Life (W30) - Visits in the First 15 Months
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): A. Age 1-5 Years
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): B. Age 6-11 Years
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