Combining the measurement of traditional drug utilization and other health care resources can provide a good measure of performane within a health care plan, but they have not been extensively developed. Following the workshop, participants should be able to select medical conditions in a population that are appropriate for drug usage performance measures, develop a set of drug‐based performance measures from well‐established treatment guidelines, develop appropriate denominators for the performance measures and monitor the results within and across health care plans. A template and the criteria development process for two drug‐based performance sets (asthma and otitis media) will be presented. The role of performance measures to evaluate trends and to describe the consequences of implementing managed care to a traditional Medicaid program will be discussed. Providers and insurers of health care who are responsible for quality of care indicators or the drug and disease evaluation process will benefit from attending this workshop.

Traditional state Medicaid programs that adopt an open managed care model must adapt their oversight from a single drug formulary to multiple formularies. Following the workshop, participants should be able to identify and describe successful strategies for obtaining and analyzing data needed to evaluate appropriateness of multiple drug formularies. Practical experience with obtaining information and creating a database containing multiple formularies, procedures to incorporate analysis of drug therapy by disease sate, and different methods used to categorize drugs for evaluation will be presented. These will be demonstrated by comparing medications used for the treatment of peptic ulcer disease by Medicaid managed care formularies in the state of Tennessee. This workshop is intended for government and healthcare industry decision makers and others involved in quality control and improvement.