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

Appendix 5. Measures Recommended for the Core Set and Posted for Public Comment

#	NQF ID^a	Measure Owner	Measure Name	EHR^b
Prevention & Health Promotion
1	0039	NCQA	Flu Shots for Adults Ages 50-64 (Collected as part of HEDIS CAHPS Supplemental Survey)
2	0421	CMS	Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up	X
3	0031	NCQA	Breast Cancer Screening	X
4	0032	NCQA	Cervical Cancer Screening	X
5	NA	RAND	Alcohol Misuse: Screening, Brief Intervention, Referral for Treatment
6	0027	NCQA	Medical Assistance With Smoking and Tobacco Use Cessation	X
7	0418	CMS	Screening for Clinical Depression and Follow-Up Plan
8	NA	NCQA	Plan All-Cause Readmission
9	0272	AHRQ	PQI 01: Diabetes, Short-term Complications
10	0273	AHRQ	PQI 02: Perforated Appendicitis
11	0274	AHRQ	PQI 03: Diabetes, Long-term Complications
12	0275	AHRQ	PQI 05: Chronic Obstructive Pulmonary Disease
13	0276	AHRQ	PQI 07: Hypertension
14	0277	AHRQ	PQI 08: Congestive Heart Failure
15	0280	AHRQ	PQI 10: Dehydration
16	0279	AHRQ	PQI 11: Bacterial Pneumonia
17	0281	AHRQ	PQI 12: Urinary Tract Infection Admission Rate
18	0282	AHRQ	PQI 13: Angina Without Procedure
19	0638	AHRQ	PQI 14: Uncontrolled Diabetes Admission Rate
20	0283	AHRQ	PQI 15: Adult Asthma
21	0285	AHRQ	PQI 16: Lower Extremity Amputations Among Patients With Diabetes
Management of Acute Conditions
22	0052	NCQA	Use of Imaging Studies for Low Back Pain	X
23	0640	TJC	HBIPS-2 Hours of Physical Restraint Use
24	0576	NCQA	Follow-Up After Hospitalization for Mental Illness
25	0476	Providence St. Vincent Medical Center	Appropriate Use of Antenatal Steroids
26	0469	Hospital Corporation of America	Elective Delivery Prior to 39 Completed Weeks Gestation
27	0648	AMA-PCPI	Timely Transmission of Transition Record (Inpatient Discharges to Home/Self Care or Any Other Site of Care)
28	0647	AMA-PCPI	Transition Record With Specified Elements Received by Discharged Patients (Inpatient Discharges to Home/Self Care or Any Other Site of Care)
Management of Chronic Conditions
29	0071	NCQA	Persistence of Beta-Blocker Treatment After a Heart Attack
30	0018	NCQA	Controlling High Blood Pressure	X
31	0074	AMA-PCPI	Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL Cholesterol	X
32	0075	NCQA	Comprehensive Ischemic Vascular Disease Care: Complete Lipid Profile and LDL-C Control Rates	X
33	0063	NCQA	Diabetes: Lipid Profile
34	0057	NCQA	Comprehensive Diabetes Care: Hemoglobin A1c Testing
35	0036	NCQA	Use of Appropriate Medications for People With Asthma	X
36	0403	NCQA	HIV/AIDS: Medical Visit
37	0105	NCQA	Antidepressant Medication Management	X
38	NA	RAND	Bipolar I Disorder 2: Annual Assessment of Weight or BMI, Glycemic Control, and Lipids
39	NA	RAND	Bipolar I Disorder C: Proportion of Patients With Bipolar I Disorder Treated With Mood Stabilizer Medications During the Course of Bipolar I Disorder Treatment.
40	NA	RAND	Schizophrenia 2: Annual Assessment of Weight/BMI, Glycemic Control, Lipids
41	NA	RAND	Schizophrenia B: Proportion of Schizophrenia Patients With Long-term Utilization of Antipsychotic Medications.
42	NA	RAND	Schizophrenia C: Proportion of Selected Schizophrenia Patients With Antipsychotic Polypharmacy Utilization.
43	0021	NCQA	Annual Monitoring for Patients on Persistent Medications
44	0541	PQA	Proportion of Days Covered (PDC): 5 Rates by Therapeutic Category
Family Experiences of Care
45	0006	AHRQ	CAHPS Health Plan Survey v. 4.0—Adult Questionnaire
46	0007	NCQA	CAHPS Health Plan Survey v. 4.0H—NCQA Supplemental Items for CAHPS 4.0 Adult Questionnaire
Availability
47	NA	NCQA	Ambulatory Care: Outpatient and Emergency Department Visits
48	NA	NCQA	Inpatient Utilization: General Hospital/Acute Care
49	0004	NCQA	Initiation and Engagement of Alcohol and Other Drug Dependence Treatment	X
50	NA	NCQA	Mental Health Utilization
51	1517	NCQA	Prenatal and Postpartum Care: Postpartum Care Rate

^a. NQF ID: National Quality Forum identification numbers are used for measures that are NQF-endorsed; otherwise, NA is used.
^b. MU = Measures with an "X" are designated Meaningful Use according by legislation; in addition, for these particular measures, electronic medical record specifications have been published and are available on the Centers for Medicare & Medicaid Services Web site.

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Page last reviewed October 2014
Page originally created December 2010

Internet Citation: Appendix 5. Measures Recommended for the Core Set and Posted for Public Comment. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://archive.ahrq.gov/news/events/nac/reports/nacqm11/appendix5.html

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

Appendix 5. Measures Recommended for the Core Set and Posted for Public Comment

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