Recorded presentation

Philip Renner, MBA, Measures Development, National Committee for Quality Assurance (NCQA), 2000 L St., N.W., Suite 500, Washington, DC 20036, Lok Wong, MHS, Quality Measurement, National Committee for Quality Assurance, 2000 L Street, NW, Suite 500, Washington D.C, DC 20036, 202 955 1784, wong@ncqa.org, Russell Mardon, PhD, Research and Analysis, NCQA, 2000 L Street, NW, Suite 500, Washington, DC 20036, and Phillipe Gwet, PhD, Research and Analysis, National Committee for Quality Assurance, 2000 L St NW, washington, DC 20036.

Objective To evaluate frequency of biennial eye examinations for glaucoma among people age 65 and older enrolled in Medicare+Choice plans, and to test the deployment of a potential new HEDIS" measure for M+C plans.

Design Observational study conducted in five M+C plans. A clinical expert panel was convened to develop measurement specifications based on existing guidelines. Analyses were run to calculate screening rates, and validate the measure.

Findings Approximately 75% of the members in the study population received some form of glaucoma screening, with plan-specific rates using adminstrative data ranging from 22.8% to 93.3%. Men and women received screening examinations at similar rates. Screening rates increased from age 65 to age 79, and then decreased. Members who had at least one eye related condition, including cataract and macular degeneration, received screening at a higher rate than those with no known eye-related conditions. People with diabetes received screening at a lower rate than the general population.

Conclusions Three quarters of the M+C members in our study were screened for glaucoma as measured using administrative data. The screening rates found exceed those found in Fee for Service Medicare, which range from 46-48%. This finding is consistent with prior literature, and represents an opportunity for improvement.

Implications Despite the promulgation of guidelines recommending glaucoma screening by specialty societies and health systems, screening rates show wide variation and room for improvement. Performance measurement for glaucoma screening can be used to demonstrate variable screening rates and to improve data capture for population management.

Learning Objectives:

• Describe clinical practice guidelines for glaucoma screening
• Discuss adherence to clinical practice guidelines in M+C health plans
• Describe how performance measurement can influence public health

Keywords: Vision Care, Elderly

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: National Committee for Quality Assurance
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employer

Recorded presentation