Reminder – Asthma Medication Ratio (AMR)
| Date: | October 26, 2023 |
| To: | Health Plan of San Joaquin (HPSJ) Contracted Primary Care Providers (PCPs), HPSJ Pediatrics |
| Type: | Educational/informal |
| Subject: | Reminder – Asthma Medication Ratio (AMR) |
| Business: | Medi-Cal Managed Care |
Healthcare Effectiveness Data Information Set (HEDIS)
Measurement Year 2023
Asthma Medication Ratio (AMR)
The following is a reminder regarding the Asthma Medication Ratio (AMR). Patients ages 5-64 years old with persistent asthma who have had a ratio of controller medications to total asthma medications of 0.50 or greater during the measurement year.
Who is evaluated:
- Patients who had 1 emergency department (ED) or acute inpatient visit with a principal diagnosis of asthma.
- Patients with 4 outpatient or observation visits with any diagnosis of asthma and at least 2 asthma medication dispensing events.
- Patients identified having persistent asthma because of at least 4 asthma medication dispensing events.
- Patients with at least 4 asthma medication dispensing events, where leukotriene modifiers or antibody inhibitors were the sole asthma medication dispensed, must have at least 1 diagnosis of asthma, in any setting, within the past 2 years.
Recommended Best Practices:
- Assess asthma symptoms at every visit to determine if preventive medication is needed.
- Discuss daily symptoms related to asthma and assess use of rescue inhaler to identify requires a controller inhaler.
- Educate patients on proper use of asthma medications.
- Discuss with patients if there have been any recent urgent care or ER visits and ask if they filled any rescue inhalers.
- Inform patients to call their provider if using more than one rescue inhaler per month.Please refer to the link provided for the most up to date covered medications:
https://medi-calrx.dhcs.ca.gov/cms/medicalrx/static-assets/documents/provider/forms-and-information/cdl/Medi-Cal_Rx_Contract_Drugs_List_FINAL.pdf
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan of San Joaquin and our services is always available on our website https://www.hpsj.com/