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PQA Medication Quality Measures in the Health Insurance Marketplace
Quality Rating System (QRS) Measure Set

The 2018 Quality Rating System (QRS) measure set for Qualified Health Plans (QHP) in the  Health Insurance Marketplace includes PQA’s measures of medication adherence, specifically, Proportion of Days Covered (PDC) – three rates:

  • PDC – Renin Angiotensin System Antagonists (RASA)
  • PDC – Diabetes All Class
  • PDC – Statins

QHP issuers that offer coverage during the 2017 coverage year will need to report the adherence measures using the standard Proportion of Days Covered (PDC) method separately for the three drug categories. The PDC adherence measures are the same as those currently included in the Medicare Part D Star Ratings. 

The Proportion of Days Covered (PDC) – three rates measures look at each of the following:  Renin Angiotensin System (RAS) Antagonists, Diabetes All Class, and Statins.

FREQUENTLY ASKED QUESTIONS

A list of frequently asked questions (FAQs) about the measures can be accessed here.    
 

QUESTIONS   -  If you have a question specific to the PQA PDC measures included in the QRS Measure Set, please complete and submit the QRS form.


REQUEST FOR NDC   
-  If you represent a QHP and are requesting the National Drug Code (NDC) lists for the PDC – three rates measures for reporting in the Quality Rating System, please complete and submit the NDC request. All others, please visit our licensing page at http://pqaalliance.org/measures/licensing.asp.

HEDIS MEASURES  -  NCQA/HEDIS measures also are included in the QRS.  If your question is specific to any of those measures, please direct your inquiries to NCQA's Policy Clarification Support (PCS) system at http://ncqa.force.com/pcs/login.

 

 

 



 
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