OHN’s internal performance measurements in 2019 were exceptional — recording increases over prior year in each of the high-priority chronic disease initiatives. 2019 was OHN’s second year of using the payor-agnostic measurement tool we developed in 2018 to track our performance on over 40 measures, using both industry standard measure specifications and internally created algorithms to integrate clinical and claims data from a variety of provider and payor data sources.Launched in 2014, QBPC is a Blue Cross and Blue Shield of LA population health and quality improvement program designed to improve the overall health of the population.
- Diabetes Mellitus - Patients with a diagnosis of type 1 or type 2 diabetes mellitus on one or more medications, either oral agent(s), insulin(s), or other anti-hyperglycemia medications are eligible for QBPC enrollment. Prediabetes, metabolic syndrome or other pre-diabetic syndromes are not eligible for QBPC enrollment. Patients who are co-managed with an endocrinologist may be enrolled in QBPC.
- Vascular Disease - Enrollment for QBPC includes any of the established diagnoses for Ischemic Vascular Disease using ICD-9 codes. Due to the extensive variety of testing that may be performed, enrollment is based on diagnostic codes; however, these diagnoses should be supported by radiologic, angiographic or functional cardiac testing that indicated arteriosclerotic pathology.
- Vascular Pharmacy Measure - This clinical quality measure includes Statin use + Proportion of Days Covered >.80
- Hypertension - Patients with a history of hypertension on one or more medications for hypertension are considered “hypertensive” for QBPC purposes regardless of blood pressure reading(s).
- Chronic Kidney Disease – Patients with a decline in kidney function for three or more months - as determined by an estimate of the Glomerular Filtration Rate (eGFR) of less than 60 mL/min/1.73 m2 OR significant albuminuria NOT on any form of renal replacement therapy including kidney transplant - are eligible for QBPC enrollment.
