Risk-adjusted, state-level measure that assesses rates of hospital admissions for ambulatory care sensitive conditions per 1,000 Medicaid HCBS participants aged 18 years and older for chronic conditions including diabetes short-term complications, diabetes long-term complications, low-extremity amputation, chronic obstructive pulmonary disease (COPD), persistent asthma, hypertension, heart failure, Parkinson disease, renal disease, and seizure disorder.

The number of Medicaid HCBS participants who had an inpatient admission for a chronic condition during the measurement period. Ambulatory care sensitive conditions for the chronic conditions rate include chronic obstructive pulmonary disease, diabetes long-term complications, diabetes short-term complications, heart failure, hypertension, lower-extremity amputation, Parkinson disease, persistent asthma, renal disease, and seizure disorder.

Adults receiving Medicaid HCBS, aged 18 years and older, within each state during the measurement period.

Denominator exclusions: acute hospital transfers, hospice and hospitalisations for obstetric conditions.

Chronic Conditions exclusion: A procedure code for lower extremity amputation AND any diagnosis for diabetes - Excluding any discharge with a diagnosis for traumatic amputation of the lower extremity or toe amputation procedure. Primary diagnosis of chronic obstructive pulmonary disease or persistent asthma - Excluding any discharge with a diagnosis for cystic fibrosis and anomalies of the respiratory system. Primary diagnosis of heart failure - Excluding any discharges with a cardiac procedure. Primary diagnosis of hypertension - Excluding any discharge with a cardiac procedure or diagnosis of State I–IV kidney disease with a dialysis procedure.

Claims data

p4qm.org/measures

p4qm.org/measures/4490