Claims and Eligibility
Education and Reference
Standards and Requirements
August 10, 2022
With the start of flu and cold season, we encourage you to talk with our members about taking antibiotics only when needed. Antibiotics don’t work against viruses, which are often the cause of acute bronchitis, colds and flu. They only treat certain bacterial infections.
Why It Matters
Closing Care Gaps
We track Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) to help monitor and improve our members’ care. AAB is a Healthcare Effectiveness Data and Information Set (HEDIS®) measure from the National Committee for Quality Assurance (NCQA). It measures the appropriate treatment for acute bronchitis/bronchiolitis, meaning antibiotics weren’t prescribed.
Tips to Consider
The CDC suggests alternatives to antibiotics for acute bronchitis and other conditions, including:
Consider sharing resources with our members, such as these from the CDC. They explain that viruses, not bacteria, cause colds and flu.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their member guide or member contract for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
HEDIS is a registered trademark of NCQA.