Pharmacotherapy was added to the parent measure to align with current guidelines, and needs to be added to this measure.​​ Proposed Solution: Update the numerators as follows: Numerator 1 (Initiation): Add medication events to numerator 1. Numerator 2 (Engagement): For patients that had an initiation medication, they need two visits or another medication event and a visit to be compliant for numerator 2. Patients with a visit for numerator 1 can be compliant with either one medication event or two additional visits.   Treatment Initiation With Medication Order   ( ["Encounter, Performed": "Alcohol and Drug Dependence Treatment"]                                   union ( ["Medication, Order": "Opiate Antagonists"] ) MedicationEvent                                                   with ( "First Dependence Diagnosis" ) FirstDiagnosed                                                                   such that MedicationEvent.relevantPeriod starts 14 days or less after day of start of FirstDiagnosed.prevalencePeriod   )   Has Continuation Of Treatments With Medication Order   Count(((["Encounter, Performed": "Alcohol and Drug Dependence Treatment"]) >= 2   union (["Medication, Order": "Opiate Antagonists"]) MedicationEvent   with("Treatment Initiation")InitiatedTreatment   such that MedicationEvent.relevantPeriod starts 34 days or less after start of InitiatedTreatment.relevantPeriod   ) = 1   )     Rationale: To align with the HEDIS parent measure which added Pharmacotherapy to align with current guidelines.​​

Final Recommendation: Update the numerators as follows: Numerator 1 (Initiation): Add medication events to numerator 1.   Numerator 2 (Engagement): For patients that had an initiation medication, they need 2 visits or another medication event and a visit to be compliant for numerator 2. Patients with a visit for numerator 1 can be compliant with either 1 medication event or 2 additional visits.