How VHAN Can Help Your Practice Address Triple-Weighted Measures

As we approach the last quarter of the year, it’s essential to focus on triple-weighted measures on your Medicare Advantage (MA) contracts. These measures—related mainly to medication adherence, diabetes control and blood pressure control—count more towards your performance than single weighted measures in the Centers for Medicare and Medicaid Service’s (CMS) pay-for-performance Star Ratings system. Triple-weighted measures play a critical role in a health plan’s ability to earn four or more Stars, the threshold at which practices can achieve a higher proportion of shared savings dollars and quality bonuses. 

Focusing on the triple-weighted measures can increase the reward for your efforts. Below are the CMS’s triple-weighted measures:

• Controlling high blood pressure   (<140/<90)
• Hemoglobin A1c control for patients with diabetes (A1c < 9) 
• Medication adherence (Proportion of days covered >80%)
  • For diabetes (diabetes medications other than insulin)  
  • For hypertension (Ace inhibitors (-prils) and Angiotension II receptor blockers (- sartans))
  • For cholesterol (statins) 
• All-cause readmissions

You can confirm which measures you are responsible for by reviewing the quality measure guides for your contracts. Find them here on VHAN Hub. 

How VHAN Can Help

One benefit of VHAN membership is the support the network provides members to help address and improve quality performance. This support includes: 

• Access to the VHAN Pharmacy Team. Many triple-weighted measures focus on medication management. While some changes to medication instructions are intentional, sometimes patients skip or delay prescription refills, change the dose or frequency, or stop taking a medication during the year. There are many reasons for medication non-adherence. If one of your patients could benefit from working with a pharmacist to address non-adherence or barriers to taking medications regularly, please reach out to us at (615) 936-2828. The Pharmacy Team can also provide a list of your patients who may benefit from your support to help them take their medications regularly. There are several other resources to support your medication adherence efforts on the VHAN Hub.
• Quality Impact Specialists (QIS).Throughout the year the QIS team performs attestation to ensure VHAN practices close quality care gaps, identify patients that meet exclusion criteria and are rewarded for the care that their patients have received.  
• Quality reports and network teams. VHAN provides quarterly quality measure reports that allow practices to use a targeted list of patients and measures that need attention. Your Clinical Quality Transformation Advisor (CQTA) can help you review your reports and focus your efforts on critical areas that will have a more significant impact on your year-end performance.  

If you have questions about how VHAN can support you in your MA contracts, please reach out to your quality advisor or contact us at info@vhan.com.