National Advisory Council Subcommittee: Identifying Quality Measures for Medicaid-eligible Adults

This section describes the overall results of the Subcommittee's deliberations and provides insights into the priorities suggested by each workgroup.

Overall Results

The Measures Inventory provided to the Subcommittee included 985 measures. Table 2 summarizes the measure selection process. A total of 301 measures were included on preliminary lists and provided to each of the four workgroups. On the first day of deliberations, the workgroups identified a first draft of measures and shared this draft with the full Subcommittee. The combined list of measures nominated by the four workgroups included 109 measures. After a second round of measure evaluation, the workgroups offered a revised list of 63 measures. The full Subcommittee voted on the priority of the 63 measures for inclusion in the core set. Based on the Subcommittee's anonymous second round of votes and the scoring methodology described above, 37 measures were selected. Some panel members expressed concerns that this reduced list failed to address some key needs (in particular, mental health and substance use). Given these concerns and the importance of the populations they represent, the Subcommittee was invited to review the list and nominate measures previously discussed. Fourteen measures were added back, making a final list of 51 measures (including 13 Prevention Quality Indicators, which were voted as a set by the Subcommittee). 

Table 3 lists the measures. Two of these added measures were not included in the initial voting process. First, Flu Shots for Adults Age 50-64 (Measure 1) was substituted because this measure is part of the National Committee for Quality Assurance HEDIS Consumer Assessment of Healthcare Providers and Systems (CAHPS®) supplement that was added and therefore less burdensome than the chart review measure discussed by the workgroup. Controlling High Blood Pressure (Measure 30) was added because of the high prevalence of this condition among Medicaid populations. Of the 51 measures, 24 are currently specified for health plan/population reporting and 23 for physician/provider reporting. Forty measures are currently specified for collection from administrative claims data, three from patient surveys and 12 from medical records or other clinical data. Eleven measures are designated for Meaningful Use incentive payments for eligible health care professionals and hospitals under HITECH. 

Table 2. Measure selection process