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
Title IV of the Children's Health Insurance Program Reauthorization Act (CHIPRA; Public Law 111-3) required the Secretary of the U.S. Department of Health and Human Services (HHS) to identify and post for public comment by January 1, 2010, an initial, recommended core set of children's health care quality measures for voluntary use by Medicaid and Children's Health Insurance Programs (CHIP), health insurance issuers and managed care entities that enter into contracts with such programs, and providers of items and services under such programs.
This background paper describes the publicly transparent, multi-stakeholder, evidence-informed process the Secretary used to identify that initial, recommended core set and the results of that process. This background paper also includes detailed information on each of the healthcare measures recommended for the initial core set.
Select to download print version of the Initial Recommended Core Set (PDF - 718 KB).
Contents
Executive Summary
Background
Legislation
AHRQ-CMS Partnership
Methods
Creation of the SNAC
Public Input
First SNAC Meeting July 22-23, 2009
Preparation
SNAC Meeting
Additional Input: Presentations
Refinements to Methodology
Other Steps and Decisions
Conclusions
First SNAC Report to the NAC
Second SNAC Meeting September 17-18, 2009
Preparation
Additional Measure Nominations
Delphi Scoring by the SNAC
SNAC Discussions
Electronic Voting Process
Discussion of Overlapping Measures
Elimination of Overlapping Measures, Merging of Some Measures, Voting
Getting to 25 Measures to Recommend to NAC
Additional Consideration of NAC-Recommended Measures
Results
Overall Summary
General Themes
Importance of all Measures
Size of the Initial, Recommended Set
Clear Needs for Technical Assistance and Time for Implementation
Improvements Needed to Meet Legislative Requirements
Paucity of Reporting to Identify Disparities
Duration of Enrollment Considerations
Need to Specify Accountable Entities
Need to Develop and Enhance Measures
Recommended Measures
Prevention and Health Promotion
Management of Acute Conditions
Management of Chronic Conditions
Family Experiences of Care
Availability of Services
References
Table
Table 1. Initial, recommended set of children's health care quality measures
Appendixes
Appendix A
A-1 Acronyms and Abbreviations
A-2 Title IV of the Children's Health Insurance Program Reauthorization Act (CHIPRA)
A-3 Agency for Healthcare Research and Quality, National Advisory Council (NAC) Subcommittee on Children's Healthcare Quality Measures for Medicaid and Children's Health Insurance Programs (SNAC)
A-4 CHIPRA HHS Federal Quality Workgroup
A-5 Public Commenters
A-6 Description of the Modified Delphi I Scoring Process
A-7 Online Measure Nominations Template
A-8 Description of the Modified Delphi Process to Rate and Select Valid, Feasible, and Important Measures
A-9 One-Page Measure Summary Template
Appendix B
Table B-1: Measures that met the Delphi-2 criteria for discussion at the September 17-18 SNAC meeting but were not part of the SNAC's top 25 initial, core recommended set
Table B-2: Measures that did not meet the Delphi-2 criteria for discussion and voting at the September 17-18 SNAC meeting
