Recommendations to Improve Children's Health Care Quality Measures
Background Report on the 2012 Process
Appendix B: Measure Scores by CHIPRA Category, Measure Name, and Scoring Round
| CHIPRA Category/Measure Topic/Subtopic | Measure Number | Measure Name and Measure Submitter | Delphi Round I Global Summary Score (Q 10) (Median Score, Interquartile Range (IQR)) | Delphi Round II Global Summary Score (Median Score, IQR) | Delphi Round III Score1 | SNAC Recommendation | CMS Recommendations for Additions to Core Set | ||
|---|---|---|---|---|---|---|---|---|---|
| Cross-Cutting Categories | |||||||||
| Duration of Enrollment and Continuity of Coverage | 0035 | Children who had inconsistent health insurance coverage in the past 12 months (CAHMI) | 6,2 | 6,3.52 | |||||
| 0078 | Coverage in Medicaid and CHIP (CHOP)3 | N/A4 | 8,2.75 | Pass | Improved Core Set | ||||
| 0079 | Duration of first observed enrollment (CHOP) | N/A | 7,3 | ||||||
| 0080 | Duration of newborn's first enrollment (CHOP) | N/A | 7,2.5 | Pass | Improved Core Set | ||||
| Availability of Services | 0023 | Children who have inadequate insurance for optimal health (CAHMI) | 6,2 | 6,3.5 | |||||
| 0036 | Children with a usual source of care when sick (CAHMI) | 6,25 | 5,2 | ||||||
| 0037 | Children with special health care needs (CSHCN) with a parent who is usually or always frustrated in their efforts to get services for the child (CAHMI) | 3,2 | |||||||
| Most Integrated Health Care Delivery Setting | 0028 | Measure of medical home for children and adolescents (CAHMI) | 6,3 | ||||||
| Family Experiences of Care | 0050 | Helpfulness of care provided: Proportion of children whose parents reported care provided was helpful or very helpful on core aspects of preventive and developmental health care (CAHMI) | 5,3 | ||||||
| 0046 | Family-centered care (FCC): (CAHMI) | 5,3 | |||||||
| 0038 | Children who receive family-centered care (CAHMI) | 4,3 | |||||||
| 0052 | Communication and experience of care: (CAHMI). | 6,26 | |||||||
| Identification of Children with Special Health Care Needs | 0025 | Children with Special Health Care Needs Screener (CSHCN Screener) (CAHMI) | 6,3 | 6.5,3.75 | |||||
| Transitions/Care Coordination | 0045 | Care coordination (CC) (CAHMI) | 5,3 | ||||||
| 0039 | Children who had problems obtaining referrals when needed (CAHMI) | 6,1 | |||||||
| 0034 | Children who have problems accessing needed specialist care (CAHMI) | 5,3 | |||||||
| 0040 | Children with special health care needs (CSHCN) who receive services needed for transition to adult health care (CAHMI) | 6,26 | 6,3 | ||||||
| 0024 | Children who receive effective care coordination of health care services when needed (CAHMI) | 6,3 | |||||||
| Patient-reported Outcomes | 0029 | Number of school days children miss due to illness (CAHMI) | 6,3 | ||||||
| 0081 | Pediatric Global Health Scale (CHOP) | N/A | 7,3.75 | ||||||
| Prevention and Health Promotion | |||||||||
| Prenatal | 0085 | Behavioral health risk assessment (PMCoE) | N/A | 7,2 | Bypass6 | Other purposes | Improved Core Set | ||
| 0086 | BMI assessment and recommended weight gain (PMCoE) | N/A | 6,2.75 | ||||||
| Perinatal | 0055 | PC-01 Elective delivery (Childbirth Connections) | 8,2 | Bypass | Bypass | ||||
| 0056 | PC-02 Cesarean section (Childbirth Connections) | 7,2 | 7,1.25 | Bypass | |||||
| 0057 | PC-05 Exclusive breast milk feeding (Childbirth Connections) | 6,4 | 5,4 | ||||||
| 0058 | Healthy term newborn (Childbirth Connections) | 7,26 | |||||||
| 0082 | Cesarean delivery for nulliparous (NSTV) women (appropriate use) (PMCoE) | N/A | 7.5,3 | ||||||
| 0083 | Episiotomy (PMCoE) | N/A | 5,3.75 | ||||||
| 0084 | Post-partum followup and care coordination (PMCoE) | N/A | 6,2.5 | ||||||
| Child and Adolescent Immunizations | 0061 | Human papillomavirus vaccine for female adolescents (NCQA) | 8,2 | Bypass | Bypass | Improved Core Set | Improved Core Set | ||
| Screening +/- Followup | |||||||||
|
0041 | Whether health care providers address parental concerns about their child's learning, development, and behavior (CAHMI) | 5,3 | ||||||
| 0051 | Administration of a Standardized, Parent-Completed Developmental & Behavioral Screening (SDBS) tool (CAHMI) | 6,2 | 5.5,1.75 | ||||||
| 0030 | Developmental screening in the first 3 years of life (CAHMI) | 5,3 | |||||||
| 0027 | Developmental screening using a parent completed screening tool (parent report, children 0-5) (CAHMI) | 5,1 | |||||||
| 0047 | Followup for children at risk for developmental, behavioral, or social delays (CAHMI) | 5,2 | |||||||
| 0048 | Composite measure of preventive and developmental health care for young children: Proportion of children who received all care components (CAHMI) | 5,2 | |||||||
|
0001 | Preventive care and screening: Screening for clinical depression and followup plan (Quality Insight PA) | 7,3 | 7,3.5 | |||||
|
0043 | Assessment of psychosocial well-being of parent(s) in the family (CAHMI) | 5,2 | ||||||
|
0044 | Assessment of smoking and substance use in the family (CAHMI). | 6,1 | ||||||
|
0060 | Blood pressure screening by age 18 (NCQA) | 7,3 | 7,3.5 | |||||
| Dental | 0032 | Children who received preventive dental care in the prior 12 months (CAHMI) | 6,3 | 7,3 | |||||
| Well Child Care Visits (WCVs) – Content | 0031 | Children who received preventive medical care in the prior 12 months (CAHMI) | 5,4 | ||||||
| 0042 | Anticipatory guidance and parental education from doctor or other health provider (CAHMI) | 5,2 | |||||||
| 0049 | Health information (CAHMI) | 4,2 | |||||||
| Sexual and Reproductive Health | 0087 | Sexual activity status among adolescents (NCINQ) | N/A | 7,3 | |||||
| Management of Acute Conditions | |||||||||
| Dental | 0026 | Children who have dental decay or cavities (CAHMI) | 7,3 | 5.5,4 | |||||
| Ambulatory Care Sensitive Conditions | 0013 | Gastroenteritis admission rate (PDI 16) (AHRQ) | 7,2 | Bypass | Bypass | ||||
| Patient Safety | Pneumothorax in neonates (PDI 5) | 6,3 | |||||||
| 0006 | Foreign body left after procedure (PDI 3) (AHRQ) | 6,3 | 4.5,2 | ||||||
| 0010 | Postoperative wound dehiscence (PDI 11) (AHRQ) | 6,3 | 5,3.75 | ||||||
| 0005 | Pressure ulcer rate (PDI 2) (AHRQ) | 7,3 | 6.5,3.75 | ||||||
| 0004 | Accidental puncture or laceration (PDI 1) (AHRQ) | 6,2 | |||||||
| 0011 | Transfusion reaction (PDI 13) (AHRQ) | 5,4 | |||||||
| 0014 | Neonatal blood stream infection rate (NQI 3) (AHRQ) | 7,3 | 7.5,2 | Bypass | |||||
| 0053 | Recording radiation exposure from diagnostic computed tomography exams (Washington University-St. Louis) | 7,2.25 | 7,2 | Bypass | Improved Core Set | ||||
| Management of Chronic Conditions | |||||||||
| Asthma | 0012 | Asthma admission rate (PDI 14) (AHRQ) | 8,2 | Bypass | Bypass | ||||
| 0059 | Medication management for people with asthma (NCQA) | 8,2 | Bypass | Bypass | Improved Core Set | Improved Core Set | |||
| Mental Health | 0033 | Children who receive needed mental health care (CAHMI) | 7,4 | 6.5,4 | |||||
| ADHD | 0088 | Accurate ADHD diagnosis (PMCoE) | N/A | 6,3 | |||||
| 0089 | Behavioral Therapy as First-Line Treatment for Preschool-Aged Children (PMCoE) | N/A | 5.1 | ||||||
| Substance Use/abuse | 0090 | Tobacco Use and Help with Quitting among Adolescents (NCINQ) | N/A | 7,2 | Bypass | Other purposes | |||
| Other | 0008 | Pediatric Heart Surgery Mortality (PDI 6) (AHRQ) | 7,3 | 7,2.5 | Did not pass | ||||
| 0009 | Pediatric Heart Surgery Volume (PDI 7) (AHRQ) | 6,2 | 5.5, 2.757 | Did not Pass | |||||
| Number of Measures | 63 | 50 | 33 | 13 | 7 | 3 | |||
1. "Pass" indicates at least 70 percent of SNAC members scored measure as "3"=high, in Delphi III, and the measure was considered for recommendation for the core set and other purposes.
2. If no more scores are shown, the measure was not included in subsequent Delphi rounds and/or not recommended for the core set or other uses by the SNAC.
3. Measure Name in Bold indicates the measure received a final recommendation from CMS as an addition to the core set for voluntary use by Medicaid and CHIP programs.
4. The CHIPRA PQMP Centers of Excellence were unable to submit their measures until mid-August; therefore, their measures were not included in Delphi Round I.
5. Measure did not proceed to Delphi II because it did not meet criteria of a score of 4 or above on Questions 11 and/or 12.
"Bypass" indicates that the measure scored highly enough in previous rounds of voting, so that it may be considered directly for recommendation for the core set and other purposes.
6. Measure number 0009 did not meet the criteria to pass to Delphi III, but was scored in Delphi III due to its linkage to measure number 0008.
Key: ADHD = attention deficit/hyperactivity disorder; AHRQ = Agency for Healthcare Research and Quality; CAHMI = Child and Adolescent Health Measurement Initiative; CC = care coordination; CHIPRA = Children's Health Insurance Program Reauthorization Act; CHOP = Children's Hospital of Philadelphia; CMS = Centers for Medicare & Medicaid Services; CSHCN = children with special health care needs; FCC = family-centered care; IQR = interquartile range; NCINQ = National Collaborative for Innovation in Quality Measurement; NCQA = National Committee for Quality Assurance; NQI = national quality indicator; NSTV = nulliparous; PA = Pennsylvania; PDI = pediatric quality indicator; PMCoE = CHIPRA Pediatric Measurement Center of Excellence; SDBS = standardized developmental and behavioral screening; SNAC = Subcommittee of the National Advisory Council on Healthcare Research and Quality; WCV = well child care visit
