PIP 2009: Adjustments to some measures
We want to ensure practices receive the credit they deserve for all PIP 2009 measures. As a result, two adjustments have been made in measuring for PIP 2009.
- Fall 2009 H1N1 outbreak and impact to generic prescribing — Due to the increased use of Tamiflu, a brand name drug, the plan-wide generic prescribing rates for October and November were reduced. As a result, your practice's generic prescribing rates may not have reflected your efforts to manage Rx costs through generic prescribing. To correct this, we removed all October/November 2009 Tamiflu prescriptions from PIP generic prescription measures. Because of this, your settlement reports may show higher percent generic scores than your year-end reports.
- Persistence of ACE/ARB statin therapy (PAAST) measure benchmark — After receiving provider feedback and actively working with network pharmacies, we realized that not all low-cost pharmacy purchases are billed as pharmacy claims. Without a claim, gaps in pharmacy data could affect medication adherence for the PAAST measure. To account for missing data, we lowered the benchmark to 34% from 38%.
These changes will be reflected in the settlement reports. Settlement reports and checks (as applicable) will mail April 15, 2010. As a reminder, reward checks are sent to your claims remittance mailing address or to your PHO/PO administrator (if contractually obligated).
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