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 acute conditions including acute bronchitis, acute heart failure, constipation, dehydration, falls, pneumonia, complicated urinary tract infection, ketoacidosis (with or without coma), malnutrition, cellulitis, sepsis, and pressure ulcers.

The number of Medicaid HCBS participants who had an inpatient admission for an acute condition during the measurement period. Ambulatory care sensitive conditions for the acute conditions rate include acute bronchitis, acute heart failure, cellulitis, complicated urinary tract infection, constipation, dehydration, falls, ketoacidosis (with or without coma), malnutrition, pneumonia, pressure ulcers, and sepsis.

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. Acute Conditions exclusions: Primary diagnosis of pneumonia - Excluding any discharge with a diagnosis of sickle cell anaemia, haemoglobin S disease or procedure or diagnosis for immunocompromised state. Primary diagnosis of complicated urinary tract infection - Excluding any discharge with a diagnosis of kidney or urinary tract disorder or procedure or diagnosis for immunocompromised state. Primary diagnosis of cellulitis or pressure ulcer - Excluding any discharge with a procedure or diagnosis for immunocompromised state.

Claims data

p4qm.org/measures

p4qm.org/measures/4490