New Pediatric Quality Core Measure Set Released by Collaborative of Public and Private Payers

About a year and a half ago, CMS, commercial health plans, Medicare and Medicaid managed care plans, purchasers, physician and other health-related professional groups, and consumers teamed up to reach consensus on core quality measures that would be reported across payers in the public and private sectors. The initiative, known as the Core Quality Measures Collaborative (CQMC), released seven sets of core measures in February 2016, which at the time did not include pediatric quality measures. But just this week, CMS released an eighth set of measures focused on children health care.

Comparing the quality of care and outcomes across different health care payers enables stakeholders to identify strengths and opportunities for improvement among various sources of health coverage. Given that over half of all Medicaid enrollees are children, and that nearly 40% of children in the U.S. depend on Medicaid to access health care, CMS has a critical leadership role to play in quality measurement, reporting and improvement for children. So we were pleased to see that CQMC has reached consensus on core pediatric measures.

There are nine measures in the CQMC pediatric set, seven of which are currently in the Medicaid and CHIP Core Set. I was particularly excited to see that the Developmental Screening Measure in the Child Core Set was included, along with childhood and adolescents immunizations; weight assessment and counseling; well child visits for ages 3-6; asthma medication management; testing for children with pharyngitis; treatment for upper respiratory infection; and chlamydia screening for female teens.

As a refresher, the CHIP Reauthorization Act of 2009 (CHIPRA) launched a number of child-health quality activities including introducing the Child Core Set of Health Care Quality Measures for Children in Medicaid and CHIP. You can read more about the Child Core Set in my Primer on Health Care Quality Measurement and Improvement for Children in Medicaid and CHIP.

According to CMS, reporting on these measures at the provider and practice level may also help to encourage reporting on the state-level Child Core Set Measures. Currently, one of the shortcomings of the Medicaid and CHIP quality work is that reporting on the core set is voluntary for states. While all states reported at least one of the 24 measures in FY 2015, the median number of measures reported by states remains at 16, the same level reported in FY 2014.

By the way, the FY 2015 data on the Child Core Set was released in May when we were all focused on protecting Medicaid coverage for children and low-income families. While CMS published a chart pack of data, it did not release a narrative report as it had in prior years. State tuned to Say Ahhh! for more discussion of changes in quality reporting for children in Medicaid and CHIP as I dig into the latest release of data.

Tricia Brooks
Tricia Brooks is a Senior Fellow at the Center for Children and Families

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