HHS established Adult and Child Core Sets of measures for the Medicaid program to standardize the measurement of healthcare quality across state Medicaid programs, assist states in collecting and reporting on measures, and facilitate use of measures for quality improvement. This is the fourth year that MAP has provided guidance to HHS on improving care for dual-eligible individuals, the third year that MAP has provided guidance on improving the Adult Core Set, and the second year that MAP has provided guidance on the Child Core Set.

In Strengthening the Core Set of Healthcare Quality Measures for Adults Enrolled in Medicaid, 2015, MAP recommends the phased addition of nine measures to the Adult Core Set to help address high-priority areas including behavioral health and reproductive health. MAP also supports continued use of all but one of the current 26 measures in the Adult Core Set and recommends the removal of one measure due to difficulty collecting data for the measure and lack of reporting from states.

In Strengthening the Core Set of Healthcare Quality Measures for Children Enrolled in Medicaid and CHIP, 2015, MAP recommends the phased addition of six measures to the Child Core Set in high-priority areas such as behavioral health and maternity care. MAP recommends the continued use of all 24 measures currently in the Child Core Set.

MAP’s report on improving care for Americans who are eligible for coverage under both Medicaid and Medicare, Advancing Person-Centered Care for Dual-Eligible Beneficiaries through Performance Measurement, recommends adding 18 new measures to the MAP Family of Measures for Dual-Eligible Beneficiaries, including 12 new behavioral health measures, one care coordination measure, and five admission/readmission measures. In an analysis of the use of measures across a range of public and private programs, MAP found that although numerous measures are frequently used, none focused on a health issue reflective of the health and social complexity that make dual-eligible beneficiaries distinct from other healthcare consumers. As a result, MAP supports more rapid development of new measures that are relevant for dual-eligible beneficiaries in areas such as person-centered, goal-directed care; access to community-based, long-term supports and services; and meeting psychosocial needs.

A special focus of MAP’s work for the dual-eligible population this fall will be measurement of care for patients with multiple chronic conditions.

“An important goal of NQF’s work on behalf of the Medicaid program is to help foster greater alignment across measures and use of the same measures across states,” said NQF President and CEO Christine K. Cassel, MD. “In doing so, we would achieve better benchmarks and a strengthened ability to compare measure results across states while reducing the measurement burden on providers.”

For more information, contact measureapplications@qualityforum.org.