Evidence-Based Rules report

Kairos Research Partners :Evidence-Based Rules report

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Evidence-Based Rules report

  • Individual gets diabetic test strips
  • Individual gets diabetic test strips every quarter
  • Individual has Emergency Room visit with no subsequent inpatient hospital admission
  • Individual is in Disease Group 3 (i.e., diagnosis of at least one chronic disease)
  • Individual is in Disease Group 4 (i.e., diagnosis of two or more chronic diseases)
  • Individual is in Disease Group 5 (i.e., diagnosis of two or more chronic diseases and diagnosis of disease-specific complications)
  • Individual is taking drug with cost greater than $400
  • Individual is taking any drug included in Black Label Medication list
  • Individual has a diagnosis of diabetes and has been screened for a retinopathy
  • Individual has a diagnosis of diabetes and is taking an ACE inhibitor or ARB
  • Individual is taking any "specialty" drug
  • Individual had Primary Care Physician visit
  • If female, individual had breast cancer screening
  • If female, individual had breast cancer screening
  • If female, individual had cervical cancer screening
  • If female, individual had HPV screening
  • Individual has diagnosis of cardiovascular disease and is taking a Statin
  • Individual had an Acute Myocardial Infarction and is taking a Beta-Blocker
  • Individual has a diagnosis of diabetes and is taking a Statin
  • Individual has a diagnosis of hypertension and is taking anti-hypertensive medication

The report is produced in Microsoft Excel format and contains individual-level data identifying if the individual is eligible for each of the criteria and, if eligible, if each person is in compliance.