Background Report for the Request for Public Comment on Initial, Recommended Core Set of Children's Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs
Background Report on request for public comment on initial, recommended core set of Children's Healthcare Quality Measures for voluntary use by Medicaid and CHIP Programs.
Appendix B-2. Measures that did not meet the Delphi-2 criteria for discussion and voting at the September 17-18 SNAC meeting
| Control Number | Measure Label | DELPHI II SCORES | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Median V | IQR | N | Median F | IQR | N | Median I | IQR | N | ||
| PREVENTION AND HEALTH PROMOTION | ||||||||||
| Prenatal/Perinatal | ||||||||||
| PHP-1A | HRSA MCH MPR #18—% of infants born to pregnant women receiving prenatal care beginning in the first trimester (data source—nvss—differs from NCQA; Medicaid/CHIP specific not available from NVSS. | 5 | 5-7 | 17 | 5 | 5-7 | 17 | 6 | 5-8 | 17 |
| PHP-26 | Percentage of low birth weight (PDI—hospital discharge data) | 6.5 | 5-7 | 18 | 7 | 6-8 | 18 | 7 | 6-7 | 18 |
| PHP-30 | MCHB National performance measure #17—percent of VLBW infants delivered at facilities for high-risk deliveries and neonates | 6 | 4.5-7 | 16 | 6 | 5-7 | 15 | 5 | 5-7 | 15 |
| PHP-30A | Under 1500g infant Not Delivered at Appropriate Level of Care | 5 | 3-5 | 18 | 5 | 3-5 | 18 | 5 | 5-7 | 18 |
| PHP-36 | Elective delivery prior to 39 weeks gestation | 6 | 4-7 | 14 | 6 | 5-7 | 14 | 5 | 4-7 | 14 |
| PHP-40 | HRSA MCH NPR MEASURE #11—% of mothers who breastfeed their infants at 6 mos of age | 6 | 5-6 | 18 | 5 | 4-6 | 18 | 6 | 6-7 | 18 |
| PHP-41 | HRSA MCH NPR #15—% of women who smoke in the last 3 months of pregnancy | 6 | 5-7 | 16 | 5 | 4-6 | 16 | 6 | 5-7 | 16 |
| Immunizations | ||||||||||
| PHP-8 | Immunization reporting (provider registry) | 5 | 4.5-6 | 16 | 5 | 3.5-7 | 16 | 5 | 3.5-7 | 16 |
| Well Child Care (ages birth-6 years) | ||||||||||
| No Measures Not Meeting All Criteria | ||||||||||
| Adolescent Preventive Services | ||||||||||
| PHP-15 | Adolescent receipt of the following seven components of care during the measurement year: BMI percentile, assessment/counseling/education on nutrition, physical activity, risk behaviors associated with sexual health/activity/preventive actions, depression screening | 5 | 5-7 | 17 | 5 | 3-6 | 17 | 7 | 6-7 | 17 |
| PHP-16 | Smoking Cessation and Prevention: adolescent tobacco users | 5 | 5-7 | 18 | 5 | 4-5 | 18 | 6 | 5-8 | 18 |
| General Screening | ||||||||||
| PHP-19 | Weight Assessment and Counseling for Nutrition and Physical Activity for children and adolescents | 6 | 5-7 | 13 | 6 | 5-7 | 13 | 7 | 7-8 | 13 |
| PHP-19B | Nutrition counseling—NCQA | 6 | 5-7 | 19 | 5 | 4-7 | 19 | 7 | 5-7 | 19 |
| PHP 19C | Physical Activity Counseling (NQCA) | 6 | 5-7 | 14 | 5 | 5-7 | 14 | 6 | 5-7 | 14 |
| PHP-29 | Lead screening rate (NCQA—1st year measure—see confidential data); note USPSTF recommendation | 6 | 5-7 | 17 | 6 | 5-7 | 17 | 6 | 4-7 | 17 |
| PHP-29A | Lead screening 2nd year—% of members who turned age 2 during the reporting period and received a lead test (data from MaineCare claims and the Maine CDC) | 5 | 4.5-6 | 16 | 5 | 4.5-7 | 16 | 5 | 4-6.5 | 16 |
| PHP-29B | Lead screening 1st year—% of members who turned age 1 during the reporting period and received a lead test (data from MaineCare Claims and Maine CDC) | 5 | 4.5-6 | 16 | 5 | 4.5-7 | 16 | 5 | 4-6.5 | 16 |
| PHP-29C | HRSA Lead screening in children by 2 years of age (data source differs from NCQA) | 6 | 4-7 | 15 | 6 | 4-7 | 15 | 6 | 4-7 | 15 |
| PHP-39 | EPSDT—Percentage of members 0-20 years old who had one or more EPSDT procedure(s) during the reporting period | 4 | 3-6 | 17 | 5 | 3-7 | 17 | 5 | 3-7 | 17 |
| Social/Behavioral Health Screening | ||||||||||
| PHP-37 | Percent of members under age 21 with a WCC visit by any provider during the measurement period who had a BH screen. | 6 | 4-7 | 19 | 5 | 3-6 | 19 | 6 | 6-7 | 19 |
| Dental/Oral Health | ||||||||||
| PHP-22A | HRSA oral health measure—the percentage of patients who had at least one dental visit during the measurement year (differs from NCQA—data source is CHCs; broader age range) | 6.5 | 6-7 | 18 | 7 | 6-8 | 18 | 7 | 7-8 | 18 |
| MANAGEMENT OF ACUTE CONDITIONS | ||||||||||
| Acute Upper Respiratory Tract Illness | ||||||||||
| No Failed Measures | ||||||||||
| Acute Otitis Externa | ||||||||||
| AC-12 | Acute Otitis Externa—Pain Assessment | 6 | 5-7 | 19 | 5 | 5-6 | 19 | 5 | 3-5 | 19 |
| Otitis Media with Effusion | ||||||||||
| AC-15 | Otitis Media with Effusion—Hearing testing | 6 | 6-7 | 19 | 6 | 5-7 | 19 | 6 | 5-7 | 19 |
| Dental | ||||||||||
| AC-8 | HRSA oral health measure—percentage of all dental patients for whom the Phase I treatment plan is completed within a 12-month period | 5 | 4-6 | 18 | 5 | 3-6 | 18 | 6 | 5-6 | 18 |
| AC-9 | HRSA oral health performance measure—percentage of all dental patients with a comprehensive or periodic recall oral exam, for whom the Phase I treatment plan is documented | 5 | 4-6 | 19 | 4 | 2-6 | 19 | 5 | 4-7 | 19 |
| Inpatient Care | ||||||||||
| AC-7 | PICU pain assessment on admission | 4 | 3-6 | 19 | 4 | 3-6 | 19 | 5 | 3-7 | 19 |
| AC-19 | Care transitions—reconciled medication list received by discharged patients | 6 | 5-7 | 19 | 4 | 3-5 | 19 | 7 | 6-8 | 19 |
| AC-22 | Care transitions—timely transmission of transition record (from input) | 6 | 4-7 | 18 | 5 | 4-6 | 18 | 6 | 5-7 | 18 |
| ED Care | ||||||||||
| AC-21 | Care transition—transition record with specified elements received by discharged patients-ED | 5 | 4-7 | 19 | 5 | 3-6 | 19 | 7 | 6-7 | 19 |
| MANAGEMENT OF CHRONIC CONDITIONS | ||||||||||
| Mental and Behavioral Health/Substance Use | ||||||||||
| ADHD Care | ||||||||||
| CC-6 | Diagnosis of ADHD in primary care for school age children and adolescents (using DSM) | 6 | 5-7 | 18 | 5 | 4-6 | 18 | 6 | 5-7 | 18 |
| Depression Care | ||||||||||
| CC-27 | Child and adolescent Major Depressive Disorder (MDD)—interview of adolescent or child | 6 | 5-7 | 17 | 5 | 4-6 | 17 | 6 | 6-8 | 17 |
| CC-28 | Child and adolescent Major Depressive Disorder (MDD)—diagnostic evaluation | 6 | 5-7 | 18 | 6 | 4-7 | 18 | 7 | 5-7 | 18 |
| CC-30 | Child and adolescent Major Depressive Disorder (MDD)—psychotherapy | 6 | 5-7 | 18 | 6 | 4-7 | 18 | 7 | 6-7 | 18 |
| CC-32 | Child and adolescent Major Depressive Disorder (MDD)—follow-up care | 6 | 4-7 | 18 | 5 | 3-7 | 18 | 7 | 6-7 | 18 |
| Other Mental Health/Behavioral Care | ||||||||||
| CC-4 | Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (ages 3-17 and 18+) | 6 | 6-7 | 19 | 6 | 5-7 | 19 | 7 | 6-7 | 19 |
| CC-35 | Medication adherence as measured by maximal gaps in days during a calendar year for ADHD and anti-psychotics medication in children | 6 | 5-7 | 17 | 6 | 4-7 | 17 | 6 | 4-7 | 17 |
| Children with Special Health Care Needs | ||||||||||
| CC-37 | CSHCN number of missed school days due to illness or injury | 4 | 3-6 | 17 | 3 | 2-6 | 17 | 6 | 4-7 | 17 |
| HIV | ||||||||||
| CC-8 | Highly active anti-retroviral treatment | 6.5 | 6-8 | 18 | 5 | 4-6 | 18 | 6 | 5-8 | 18 |
| Asthma | ||||||||||
| CC-25 | Percentage of patients for whom there is documentation that a written asthma management plan was provided to the patient or the patient's caregiver OR at minimum instructions on under what conditions the patient's doctor should be contacted or the patient should go to the emergency room. |
6 | 5-7 | 17 | 5 | 4-6 | 17 | 6 | 5-7 | 17 |
| Chronic Disease Identified through Newborn Screening | ||||||||||
| CC-12 | Timely follow-up of positive newborn screens | 6 | 5-7 | 18 | 5 | 4-6 | 18 | 7 | 7-8 | 18 |
| Diabetes | ||||||||||
| CC-15 | Annual urine protein screening (adolescents with diabetes > 16 years-old) | 6 | 5-7 | 19 | 7 | 6-7 | 19 | 6 | 6-7 | 19 |
| CC-21 | Hemoglobin A1c test for pediatric patients | 6 | 3-7 | 13 | 7 | 4-8 | 13 | 6 | 4-8 | 15 |
| End-Stage Renal Disease | ||||||||||
| No Failed Measures | ||||||||||
| FAMILY EXPERIENCES WITH CARE | ||||||||||
| HEDIS CAHPS® for Children Without Chronic Conditions | ||||||||||
| No Failed Measures | ||||||||||
| HEDIS CAHPS® for Children with Chronic Conditions | ||||||||||
| No Failed Measures | ||||||||||
| Other Family/Patient Experiences of Care Measures | ||||||||||
| FEC-2 | Helpfulness of counseling (adolescent reported) | 5 | 3-6 | 19 | 5 | 3-6 | 19 | 5 | 4-7 | 19 |
| FEC-3 | Communication and experience of care (adolescent reported) | 5 | 4-6 | 19 | 5 | 3-6 | 19 | 5 | 4-7 | 19 |
| FEC-4 | Dental CAHPS® (overall ratings of dentist, dental plan, dental care, office staff) | 6 | 4-7 | 19 | 5 | 4-7 | 19 | 6 | 5-7 | 19 |
| MOST INTEGRATED HEALTHCARE SYSTEMS | ||||||||||
| MIH-2 | Medical home measure using subset of HEDIS CAHPS® MEDICAID 4.0 survey items | 5 | 4-7 | 16 | 5 | 4-6.5 | 16 | 7 | 5-8.5 | 16 |
| AVAILABILITY OF SERVICES | ||||||||||
| AV-1 | Unduplicated members served per provider | 4 | 2-5 | 18 | 4 | 2-7 | 18 | 5 | 2-6 | 18 |
| Use of Services | ||||||||||
| US-1 | Utilization of ambulatory services | 4.5 | 3-6.5 | 16 | 7 | 6-7.5 | 16 | 6 | 3-7 | 16 |
| US-2 | Outpatient drug utilization—per member per year average number of prescriptions | 4 | 2-5 | 15 | 7 | 6-7 | 15 | 5 | 3-7 | 15 |
| US-3 | Utilization of inpatient care | 4 | 2.5-6.5 | 16 | 7 | 6-8 | 16 | 6 | 3-6 | 16 |
| Access to Services | ||||||||||
| HEALTH STATUS | ||||||||||
| HS-2 | PROMIS Pediatric item Banks: physical function, emotional distress, social role relationship, fatigue, pain, and asthma | 6 | 3-7 | 18 | 5 | 3-6 | 18 | 6 | 5-6 | 18 |
| DURATION OF ENROLLMENT | ||||||||||
| D-1 | Prospective duration measure | 6.5 | 5-8 | 18 | 6 | 5-8 | 18 | 6 | 5-7 | 18 |
Key:
V = Validity
F = Feasibility
I = Importance
IQR = Inter-Quartile Range
N = Number of Subcommittee members rating measure
