Identifying Children’s Health Care Quality Measures for Medicaid and CHIP: An Evidence-Informed, Publicly Transparent Expert Process

Abstract

An open national public process combined with an evidence-informed evaluation methodology resulted in identification of a balanced, grounded, and parsimonious core set of measures that should become feasible to implement on a widespread scale over time.

A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents

“…Managed care organizations are interested in immunization and preventive care visit rates, which are Healthcare Effectiveness Data and Information Set (HEDIS) quality measures. [33][34][35][36][37] However, managed care organizations may not have accurate family contact information and families may not respond to reminders emanating from managed care plans.…”

National Quality Measures for Child Mental Health Care: Background, Progress, and Next Steps

“…32,33 Content gaps led to recommendations for new measures for substance abuse care and mental health treatment as well as in several areas relevant to child mental health: specialty care, inpatient care, availability of services, coordination of care, medical home, family experiences of care, and outcomes. 27,31,34,35 Furthermore, the SNAC strongly encouraged new quality measures to be aligned with the priorities of state Medicaid and CHIP agencies, 36,37 providers, and parents. 38,39 …”

“…Details of the methods and administrative review pathways before final submission of the initial core set of measures are described elsewhere. 27,28,31 In addition to selecting measures, the SNAC provided guidance to the Pediatric Quality Measures Program. It found that measures lacked the capacity to stratify adherence according to race/ethnicity, tribe, socioeconomic state, or special health care need status, characteristics called for in the CHIPRA legislation.…”

“…27 A multidisciplinary AHRQ National Advisory Council Subcommittee on Children' s Healthcare Quality Measures for Medicaid and Children's Health Insurance Programs (SNAC) was formed in May 2009. The SNAC was charged with establishing quality measure evaluation criteria, identifying a strategy for gathering measures, and applying the evaluation criteria to the measures.…”

“…The Oxford Centre for Evidencebased Medicine (CEBM) 42 has put together detailed methods for conducting these kinds of ratings, and all of the CHIPRA measures were reviewed according to the CEBM standards. 27 The CEBM protocol involves assigning a letter grade of A (the best evidence) to D (the worst) for the quality of the evidence for a given measure based on the types of studies that have been conducted to validate its use as a standard. A letter grade of A corresponds to consistent level 1 studies (randomized controlled trials [RCTs]).…”