NCQA Adds Measure to Responsible Antibiotic Use Program
December 9, 2024 · NCQA Communications
NCQA, with support from The Pew Charitable Trusts, has updated the Responsible Stewards of Antibiotic Use Program by adding a measure: Antibiotic Utilization for Respiratory Conditions (AXR). The program highlights health plans that perform well on four HEDIS® antibiotic use measures and shows how plans promote appropriate antibiotic prescribing and overall prescribing for respiratory conditions.
Responsible Stewards of Antibiotic Use
NCQA’s HEDIS measure set includes antibiotic prescribing measures for bronchitis/bronchiolitis, upper respiratory infection, pharyngitis and respiratory conditions. Responsible stewards of antibiotics are determined based on four antibiotic prescribing measures.
| Measure | What the Measure Evaluates |
|---|---|
| Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) | The percentage of episodes for members 3 months of age and older with a diagnosis of acute bronchitis/bronchiolitis that did not result in an antibiotic dispensing event. |
| Appropriate Treatment for Upper Respiratory Infection (URI) | The percentage of episodes for members 3 months of age and older with a diagnosis of URI that did not result in an antibiotic dispensing event. |
| Appropriate Testing for Pharyngitis (CWP) | The percentage of episodes for which members 3 years of age and older with a diagnosis of pharyngitis received a group A streptococcus test for antibiotics dispensed. |
| Antibiotic Utilization for Respiratory Conditions (AXR) | The percentage of episodes for members 3 months of age and older with a diagnosis of a respiratory condition that resulted in an antibiotic dispensing event. |
Addition of AXR Measure
In 2023 NCQA updated its methodology for determining high performers and included the AXR measure for identifying plans that are responsible stewards of antibiotic use. Find NCQA’s methodology report here.
The Big Picture
Antibiotics are frequently prescribed for viral infections, where they are not warranted. Inappropriate antibiotic use can expose patients to medication side-effects and can lead to antibiotic resistance—where drugs designed to kill germs like bacteria no longer work. Nearly 3 million antibiotic-resistant infections and more than 35,000 deaths occur in the United States each year, according to the CDC’s 2019 Antibiotic Resistance Threats Report.
Improving antibiotic prescribing in outpatient settings can help improve public health and ensure high quality of care for patients. Health plans are well positioned to monitor prescribing across outpatient settings, share measure results with clinician groups and educate members and clinicians to reduce inappropriate antibiotic prescribing. With the inclusion of the AXR measure, health plans can monitor antibiotic use for respiratory conditions overall.
Find the latest information about the program on NCQA’s website.
