Identifying Health Care Quality Measures for Medicaid-Eligible Adults: Background Report

1

Adherence to Antipsychotics for Individuals With Schizophrenia

CMS-QMHAG

I=2
E=8
NW=2

Measure readiness, feasibility, and burden were cited. Commenters also believe measures should be NQF-endorsed.

2

Adherence to Mood Stabilizers for Individuals With Bipolar I Disorder

CMS-QMHAG

I=2
E=8
NW=2

Measure readiness, feasibility, and burden were cited. Commenters also believe measures should be NQF-endorsed.

3

Ambulatory Care: Outpatient and Emergency Department Visits

NCQA

I=2
E=4
NW=1

Appropriateness and not being NQF-endorsed are the main concerns cited.

4

Annual Monitoring for Patients on Persistent Medications

NCQA

I=2
E=4
NW=1

Burden and reportability are the main issues cited.

5

Antidepressant Medication Management

NCQA

I=3
E=4
NW=1

Commenters question the usefulness and readiness of this measure.

6

Bipolar I Disorder 2: Annual Assessment of Weight or BMI, Glycemic Control, and Lipids

RAND

I=2
E=8
NW=3

Measure readiness, feasibility, and burden were cited. Commenters also believe measures should be NQF-endorsed.

7

Breast Cancer Screening

NCQA

I=4
E=3
NW=2

Commenters suggest this measure needs more work.

8

CAHPS Health Plan Survey v. 4.0—Adult Questionnaire

AHRQ

I=2
E=5
NW=1

Commenters are concerned additional technical assistance will be required for the CAHPS measures, and that they should not be done annually.

9

CAHPS Health Plan Survey v. 4.0H—NCQA Supplemental Items for CAHPS 4.0 Adult Questionnaire

NCQA

I=3
E=4
NW=1

Commenters are concerned additional technical assistance will be required for the CAHPS measures, and that they should not be done annually.

10

Cervical Cancer Screening

NCQA

I=4
E=2
NW=3

Commenters suggest this measure needs more work.

11

Comprehensive Diabetes Care: Hemoglobin A1c Testing

NCQA

I=4
E=3
NW=0

The majority of comments support this measure, however burden was also cited.

12

Comprehensive Diabetes Care: Lipid Profile

NCQA

I=1
E=3
NW=0

Commenters cited burden as the main issue of this measure.

13

Comprehensive Ichemic Vascular Disease Care: Complete Lipid Profile and LDL-C Control Rates

NCQA

I=1
E=5
NW=1

Commenters suggest excluding this measure until EMRs have been more widely adopted.

14

Controlling High Blood Pressure

NCQA

I=2
E=3
NW=1

Burden was the main issue cited.

15

Coronary Artery Disease (CAD): Lipid Control

AMA, ACCF, AHA

I=0
E=6
NW=0

Commenters suggest excluding this measure until EMRs have been more widely adopted.

16

Flu Shots for Adults Ages50-64 (Collected as part of HEDIS CAHPS Supplemental Survey)

NCQA

17

Follow-Up After Hospitalization for Mental Illness

NCQA

I=3
E=3
NW=2

Comments were split for this measure. Commenters question reportability.

18

HBIPS-2 Hours of Physical Restraint Use

TJC

I=1
E=6
NW=0

Issues cited include: burden, feasibility, appropriateness, and reportability.

19

HIV/AIDS: Medical Visit

NCQA

I=0
E=4
NW=1

Commenters cite this is not a reportable measure.

20

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

NCQA

I=3
E=5
NW=1

Not reportable is an issue cited.

21

Inpatient Utilization: General Hospital/Acute Care

NCQA

I=1
E=5
NW=1

Appropriateness, burden, and not being NQF-endorsed are the main concerns cited.

22

Medical Assistance With Smoking and Tobacco Use Cessation

NCQA

I=5
E=3
NW=1

The majority of comments support this measure. Non-supports suggest further clarification.

23

Mental Health Utilization

NCQA

I=2
E=5
NW=2

Appropriateness and not being NQF-endorsed are the main concerns cited.

24

PC-01 Elective Delivery

Hospital Corporation of America, TJC

I=2
E=7
NW=2

Burden, appropriateness, and feasibility are the main issues cited against this measure.

25

PC-03 Antenatal Steroids

Prov/CWISH/NPIC/QAS/TJC

I=1
E=6
NW=1

Issues cited include burden, appropriateness, and feasibility.

26

Persistence of Beta-Blocker Treatment After a Heart Attack

NCQA

I=2
E=3
NW=1

Commenters cited burden, reportablility, and usefulness of this measure.

27

Plan All-Cause Readmission

NCQA

I=1
E=7
NW=1

Burden and not being NQF-endorsed are the two reasons why there is little support for this measure.

28

Polytherapy With Oral Antipsychotics

CMS-QMHAG

I=2
E=9
NW=2

Measure readiness, feasibility, and burden were cited. Commenters also believe measures should be NQF-endorsed.

29

PQI 01: Diabetes, Short-term Complications Admission Rate

AHRQ

I=2
E=7
NW=2

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

30

PQI 02: Perforated Appendicitis Admission Rate

AHRQ

I=2
E=8
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

31

PQI 03: Diabetes, Long-term Complications Admission Rate

AHRQ

I=2
E=7
NW=2

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

32

PQI 05: Chronic Obstructive Pulmonary Disease (COPD) Admission Rate

AHRQ

I=2
E=7
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

33

PQI 07: Hypertension Admission Rate

AHRQ

I=2
E=7
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

34

PQI 08: Congestive Heart Failure Admission Rate

AHRQ

I=2
E=7
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

35

PQI 10: Dehydration Admission Rate

AHRQ

I=2
E=7
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

36

PQI 11: Bacterial Pneumonia Admission Rate

AHRQ

I=1
E=8
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

37

PQI 12: Urinary Tract Infection Admission Rate

AHRQ

I=2
E=7
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

38

PQI 13: Angina Without Procedure

AHRQ

I=2
E=7
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

39

PQI 14: Uncontrolled Diabetes Admission Rate

AHRQ

I=2
E=6
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

40

PQI 15: Adult Asthma Admission Rate

AHRQ

I=2
E=7
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

41

PQI 16: Rate of Lower Extremity Amputations Among Patients With Diabetes

AHRQ

I=2
E=8
NW=1

Burden, appropriateness, and feasibility are the main issues cited against the PQI measures.

42

Prenatal and Postpartum Care: Postpartum Care Rate

NCQA

I=3
E=5
NW=1

Burden and not being NQF-endorsed are the main concerns cited.

43

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up

CMS

I=2
E=5
NW=2

Suggest using the HEDIS BMI measure. Burden was also cited.

44

Proportion of Days Covered (PDC): 3 Rates by Therapeutic Category

PQA

I=1
E=7
NW=1

Commenters question the readiness and feasibility of this measure.

45

Schizophrenia 2: Annual Assessment of Weight/BMI, Glycemic Control, Lipids

RAND

I=2
E=8
NW=3

Measure readiness, feasibility, and burden were cited. Commenters also believe measures should be NQF-endorsed.

46

Screening and Brief Intervention for Alcohol Misuse

RAND

I=2
E=7
NW=1

Burden and not being NQF-endorsed are the main reasons this measure is not supported.

47

Screening for Clinical Depression and Follow-Up Plan

CMS

I=2
E=5
NW=2

Main issue cited is burden.

48

Timely Transmission of Transition Record (Inpatient Discharges to Home/Self Care or Any Other Site of Care)

AMA

I=1
E=8
NW=0

Burden and feasibility are the main issues cited against this measure. Commenters suggest this measure not be included until EMRs have been adopted.

49

Transition Record With Specified Elements Received by Discharged Patients (Inpatient Discharges to Home/Self Care or Any Other Site of Care)

AMA

I=1
E=9
NW=1

Burden and feasibility are the main issues cited against this measure. Commenters suggest this measure not be included until EMRs have been more widely adopted.

50

Use of Appropriate Medications for People With Asthma

NCQA

I=2
E=2
NW=0

Comments were split for this measure.

51

Use of Imaging Studies for Low Back Pain

NCQA

I=2
E=3
NW=1

Burden was cited and the usefulness of the measure was questioned.