Configurator · Step 3 / 7 · 1440
Configurator
Setup · Aetna MA HMO · Northeast Region
Module 06 of 06 · Contract & Configuration

Configurator · Quality Programs

Step 3 of 7 · Define quality measures, thresholds, and Doppler triage rules for this contract
Step 1
Contract
Step 2
Population
3
Step 3
Quality & Triage
4
Step 4
VIDA
5
Step 5
Devices
6
Step 6
IRIS Rules
7
Step 7
Review
Editing Aetna MA HMO · Northeast Region · Effective Jan 1, 2026 · Draft v0.4
★ MA Stars 2026 · template applied
A Active Programs 3 of 5 enabled
MA Stars Quality
CMS Star Ratings program — measures, contract weights, period management
RPM (CPT 99453/99454/99457/99458)
Remote patient monitoring — device-derived vitals, BIM threshold tracking
CCM (CPT 99490/99439)
Chronic care management — care coordination time tracking
PCM (Principal Care Management)
Single-condition focused care management
BHI (Behavioral Health Integration)
PHQ-9 / GAD-7 cadenced screening + collaborative care model
B CQID Quality Measures 9 active · MA Stars 2026 spec
C10 Wt 3
Diabetes A1c < 9%
C11 Wt 3
Hypertension Control
C12 Wt 3
SUPD Statin Use
D08 Wt 2
Statin Adherence (PDC)
D09 Wt 2
Annual Wellness Visit
C04 Wt 1
Influenza Vaccine
C05 Wt 3
BHI / PHQ-9 Screen
C06 Wt 1
Falls Risk Screening
D04 Wt 1
Med Reconciliation Post-D/C
Click a measure to edit numerator / denominator / cut-points. + Add custom measure
C Doppler Triage Thresholds 5 rules · 2 modified from default
Post-discharge LACE+ trigger Modified
Trigger when LACE+
Bucket Assignment
EMERGENT
PHQ-9 severity escalation
Trigger when PHQ-9
Bucket Assignment
EMERGENT
CHF weight gain alert Modified
Trigger when Δ weight
Bucket Assignment
EMERGENT
BIM 99454 reading-day risk
When days remaining
Bucket Assignment
STARS / GAP
CQID gap-to-period proximity
When period close
Bucket Assignment
STARS / GAP
Configuration progress
43% complete · Step 3 of 7
Last saved 2 min ago · 14 changes pending