PDC: Proportion of Days Covered — multiple drug classes
PDC ≥80% for: statins, RAS antagonists (ACE/ARB), and oral diabetes meds. Three separate Star measures.
Measure description
PDC ≥80% for: statins, RAS antagonists (ACE/ARB), and oral diabetes meds. Three separate Star measures.
Eligible population
Members on chronic medications
Performance drivers
Highest-weighted Star adherence measures.
Documentation & PA strategy
90-day fills, mail-order, refill reminders. Adherence drives plan ratings.
Why HEDIS matters for prior authorization
Health plans align prior authorization criteria with HEDIS measures: documenting your patient meets the HEDIS definition often streamlines or eliminates PA hurdles. For Medicare Advantage in particular, plans are heavily incentivized via Star Ratings to push members and providers toward measure compliance, which translates into faster approvals for measure-aligned services.
Frequently asked questions
What does HEDIS measure PDC measure?
PDC ≥80% for: statins, RAS antagonists (ACE/ARB), and oral diabetes meds. Three separate Star measures.
What drives performance on this measure?
Highest-weighted Star adherence measures.
How should clinicians document for this measure?
90-day fills, mail-order, refill reminders. Adherence drives plan ratings.
What is the eligible population?
Members on chronic medications
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