SPC: Statin Therapy for Patients with Cardiovascular Disease
Product Line: Medicaid, Medicare, Marketplace

Statin Therapy for Patients with Cardiovascular Disease (SPC) is a HEDIS measure that focuses on patients and their adherence to at least one high or moderate-intensity statin medication therapy during the measurement year.  

Service Needed

Male patients 21-75 years of age and female patients 40-75 years of age, with a diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD) and being treated with and remain taking a high or moderate-intensity statin medication.

Two rates reported for this measure are:

1. The percentage of patients who are dispensed at least one high or moderate-intensity statin medication during the measurement year.
2. Percentage of patients who remain on a high or moderate-intensity statin medication for at least 80 percent of the treatment period.

Tips for Attainment:

• At each visit, review the medication list and ask if there are any issues with filling or taking medications as prescribed. If there are any problems/issues with the medication, open-ended questions will assist you with solutions and remove patient barriers to adherence.
• Educate members on the purpose of the medication, including how often to take the medication and possible side effects. Advise member to contact provider's office if side effects occur or are suspected.
• Assess health literacy to determine need for additional support in medication management.
• Offer a 100-day supply of medication to members, if stable.
• Encourage member to sign up with their retail or mail-order pharmacy.
• Reminder calls, emails, text messages or mailings can assist with ensuring members do not miss scheduled appointments.
• Schedule an annual visit or follow-up visit before the member leaves the office.
• Ensure member completes any required labs such as cholesterol, kidney values (both blood and urine) and/or A1c

Buckeye Initiatives:

Weekly Outreach

1. Data analytics team generates weekly report identifying BHP members with diagnosis of ASCVD and no record of statin therapy
2. Pharmacy team makes up to 2 fax attempts to each provider for each identified member to request provider to evaluate if statin therapy is appropriate for member
3. No response from fax outreach, then Buckeye clinical pharmacist (when appropriate) attempts to contact provider to review and resolve the opportunity.
4. For members currently taking statin therapy but fall below 80% adherence – fax outreach is made to provider to alert them that member is non-adherent to their statin therapy. Cardiovascular disease (CVD) is the leading cause of morbidity and death in the US, resulting in more than 1 of every 4 deaths.1 Coronary heart disease is the single leading cause of death and accounts for 43% of deaths attributable to CVD in the US.

In 2019, an estimated 558 000 deaths were caused by coronary heart disease and 109 000 deaths were caused by ischemic stroke. Men have a higher overall prevalence of and mortality from CVD, although women experience higher mortality from certain cardiovascular events, such as stroke. On average, men experience CVD events earlier in life compared with women. The prevalence of CVD also differs by race and ethnicity. Among both sexes, Black adults have the highest prevalence of CVD.

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults
US Preventive Services Task Force Recommendation Statement

2024 Heart Disease and Stroke Statistics Update Fact Sheet (PDF)

For more information and improvement tips see the SPC page of our HEDIS Reference Guide (PDF).