NQF

Version Number: 27.7
Meeting Date: May 24-25, 2017

Measure Applications Partnership
Medicaid Child Discussion Guide

Key Tips

Agenda

Agenda Synopsis

Day 1: May 23, 2017  
8:30 AM   Breakfast
9:00 AM   Welcome, Introductions, and Review of Meeting Objectives
9:10 AM   Introductions of Task Force Members and Disclosures of Interest
9:20 AM   Overview of Meeting Materials and Key Points from Staff Review of Core Set
9:50 AM   Key Considerations from CMS
10:00 AM   CMS/State Perspectives Panel
10:15 AM   CMS/State Perspectives Panel
11:00 AM   Break
11:15 AM   Measure-Specific Recommendations on Strengthening the Adult Core Set
12:45 PM   Opportunity for Public Comment
1:00 PM   Lunch
1:30 PM   Continue Measure-Specific Recommendations on Strengthening the Adult Core Set
2:50 PM   Opportunity for Public Comment and Break
3:15 PM   Prioritizing Remaining Measure Gap Areas
3:50 PM   Opportunity for Public Comment
4:00 PM   Adjourn for the Day

Day 2: May 24, 2017  
8:30 AM   Breakfast
9:00 AM   CEO Welcome Remarks
9:10 AM   Welcome
9:20 AM   Introductions of Task Force Members and Disclosures of Interest for the MAP Child Taskforce Members
9:30 AM   Key Considerations from CMS
9:40 AM   CMS/State Perspectives Panel
9:55 AM   CMS/State Perspectives Panel
10:35 AM   Break
10:50 AM   Issues of Shared Importance: Adult and Child Continuum of Care: Looking at Maternal and Infant Health Measures across the Core Sets
Measures Recommended by Task Force Members   Gap Area: Maternal and reproductive health
12:30PM   Opportunity for Public Comment
12:40 PM   Lunch
1:15 PM   Continue Issues of Shared Importance: Adult and Child Continuum of Care: Looking at Asthma Measures across the Core Sets
Measures Recommended by Task Force Members   Gap Area: Asthma
2:55 PM   Break
3:10 PM   Supporting States’ Ability to Report Measures and Recommendations to Strengthen the Core Sets
3:50 PM   Opportunity for Public Comment
4:00 PM   Summarize Progress and Adjourn for the Day

Day 3: May 25, 2017  
8:30 AM   Breakfast
9:00 AM   Welcome Back
9:15 AM   Overview of Meeting Materials and Key Points from Staff Review of Core Set
9:45 AM   CMS/State Perspectives Panel
10:00 AM   CMS/State Perspectives Panel
10:40 AM   Break
10:55 AM   Measure-Specific Recommendations on Strengthening the Child Core Set
12:25 PM   Opportunity for Public Comment
12:35 PM   Lunch
1:05 PM   Continue Measure-Specific Recommendations on Strengthening the Child Core Set
2:35 PM   Opportunity for Public Comment and Break
3:00 PM   Prioritizing Remaining Measure Gap Areas
3:50 PM   Opportunity for Public Comment
4:00 PM   Summarize Next Steps and Adjourn Meeting
Measures Recommended by Task Force Members   Gap Area: Care coordination
   Gap Area: Cost measures
   Gap Area: Mental health
   Gap Area: Sickle cell disease


Full Agenda

Day 1: May 23, 2017  
8:30 AM   Breakfast
9:00 AM   Welcome, Introductions, and Review of Meeting Objectives
Harold Pincus, Medicaid Adult Task Force Chair
Debjani Mukherjee, Senior Director, NQF


9:10 AM   Introductions of Task Force Members and Disclosures of Interest
Elisa Munthali, VP Quality Measurement, NQF


9:20 AM   Overview of Meeting Materials and Key Points from Staff Review of Core Set
Miranda Kuwahara, Project Analyst, NQF
  • What do we know about states’ uptake of measures?
  • What do we know about states’ performance on measures?
  • Patterns apparent in technical assistance requests
  • Core set measure updates (maintenance, loss of endorsement, new endorsement)


  • 9:50 AM   Key Considerations from CMS
    Karen Matsuoka, PhD, CMCS Chief Quality Officer and Director, Division of Quality and Health Outcomes


    10:00 AM   CMS/State Perspectives Panel
    Deirdra Stockmann, PhD, Division of Quality and Health Outcomes


    10:15 AM   CMS/State Perspectives Panel
    Judy Zerzan, MD, MPH, Chief Medical Officer, Colorado Department of Health Care Policy and Financing


    11:00 AM   Break
    11:15 AM   Measure-Specific Recommendations on Strengthening the Adult Core Set
    Harold Pincus
    Shaconna Gorham
  • Examine measures with low reporting uptake
  • Feasibility of states collecting and reporting the measure
  • Review and select measures to fill gap areas


  • 12:45 PM   Opportunity for Public Comment
    1:00 PM   Lunch
    1:30 PM   Continue Measure-Specific Recommendations on Strengthening the Adult Core Set
    Harold Pincus
    Shaconna Gorham
  • Continue to review and select measures to fill gap areas
  • Rank new measures selected for potential addition to the set


  • 2:50 PM   Opportunity for Public Comment and Break
    3:15 PM   Prioritizing Remaining Measure Gap Areas
    Harold Pincus
    Debjani Mukherjee
  • Set the stage for MAP’s next review and/or guide development efforts
  • Future opportunities to fill gap areas such as measure concepts


  • 3:50 PM   Opportunity for Public Comment
    Harold Pincus


    4:00 PM   Adjourn for the Day
    Harold Pincus



    Day 2: May 24, 2017  
    8:30 AM   Breakfast
    9:00 AM   CEO Welcome Remarks
    Shantanu Agrawal, MD, President and CEO, NQF


    9:10 AM   Welcome
    Richard Antonelli, Child Task Force Chair
    Harold Pincus, Adult Task Force Chair
  • Review objectives for joint discussion
  • Share relevant highlights from previous day


  • 9:20 AM   Introductions of Task Force Members and Disclosures of Interest for the MAP Child Taskforce Members
    Elisa Munthali, VP Quality Measurement, NQF


    9:30 AM   Key Considerations from CMS
    Karen Matsuoka, PhD, CMCS Chief Quality Officer and Director, Division of Quality and Health Outcomes


    9:40 AM   CMS/State Perspectives Panel
    Lekisha Daniel-Robinson, MSPH, CMS Maternal-Infant Health Technical Director


    9:55 AM   CMS/State Perspectives Panel
    Mary Applegate, MD, FAAP, FACP, Medical Director, Ohio Medicaid


    10:35 AM   Break
    10:50 AM   Issues of Shared Importance: Adult and Child Continuum of Care: Looking at Maternal and Infant Health Measures across the Core Sets
    Richard Antonelli
    Harold Pincus
    Shaconna Gorham
  • Measure continuum for discussion
  • Point of view from state representative(s)
  • Identify measures to fill gap areas in the Child and Adult Core Sets
  • Vote on inclusion of measures in Child Core Set, if any
  • Vote on inclusion of measures in Adult Core Set, if any, and relative priority for addition based on previous day’s discussion


  • Measures Recommended by Task Force Members   Gap Area: Maternal and reproductive health
    Measures for Discussion and Voting
    1. NQF #0480 PC-05 Exclusive Breast Milk Feeding
      • Description: PC-05 assesses the number of newborns exclusively fed breast milk during the newborn's entire hospitalization. This measure is a part of a set of five nationally implemented measures that address perinatal care (PC-01: Elective Delivery, PC-02: Cesarean Birth, PC-03: Antenatal Steroids, PC-04: Health Care-Associated Bloodstream Infections in Newborns). (Measure Specifications; Summary of NQF Endorsement Review)


    2. NQF #2830 PC-05 Exclusive Breast Milk Feeding
      • Description: PC-05 assesses the number of newborns exclusively fed breast milk during the newborn's entire hospitalization. This measure is a part of a set of five nationally implemented measures that address perinatal care (PC-01: Elective Delivery, PC-02: Cesarean Section, PC-03: Antenatal Steroids, PC-04: Health Care-Associated Bloodstream Infections in Newborns). PC-05, Exclusive Breast Milk Feeding, is one of two measures in this set that have been reengineered as eCQMs and are included in the EHR Incentive Program and Hospital Inpatient Quality Reporting Program. (Measure Specifications; Summary of NQF Endorsement Review)


    3. NQF #2903: Contraceptive Care -- Most and Moderately Effective Methods
      • Description: The percentage of women aged 15-44 years at risk of unintended pregnancy that is provided a most effective (i.e., sterilization, implants, intrauterine devices or systems (IUD/IUS)) or moderately effective (i.e., injectables, oral pills, patch, ring, or diaphragm) FDA-approved method of contraception.The proposed measure is an intermediate outcome measure because it represents a decision that is made at the end of a clinical encounter about the type of contraceptive method a woman will use, and because of the strong association between type of contraceptive method used and risk of unintended pregnancy. (Measure Specifications; Summary of NQF Endorsement Review)


    12:30PM   Opportunity for Public Comment
    12:40 PM   Lunch
    1:15 PM   Continue Issues of Shared Importance: Adult and Child Continuum of Care: Looking at Asthma Measures across the Core Sets
    Richard Antonelli
    Harold Pincus
    Shaconna Gorham
  • Measure continuum for discussion
  • Point of view from state representative(s)
  • Identify measures to fill gap areas in the Child and Adult Core Sets
  • Vote on inclusion of measures in Child Core Set, if any
  • Vote on inclusion of measures in Adult Core Set, if any, and relative priority for addition based on previous day’s discussion


  • Measures Recommended by Task Force Members   Gap Area: Asthma
    Measures for Discussion and Voting
    1. NQF #1800: Asthma Medication Ratio (AMR)
      • Description: The percentage of members 5–64 years of age who were identified as having persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater during the measurement year (Measure Specifications; Summary of NQF Endorsement Review)


    2:55 PM   Break
    3:10 PM   Supporting States’ Ability to Report Measures and Recommendations to Strengthen the Core Sets
    Richard Antonelli
    Debjani Mukherjee
  • Discuss methodological issues such as stratification for addressing QI across age groups and multiple conditions
  • Point of view from state representative(s)
  • Task Force discussion on issues at state level
  • What do states need for improving measure reporting rates
  • Recommendations for HHS/CMS


  • 3:50 PM   Opportunity for Public Comment
    4:00 PM   Summarize Progress and Adjourn for the Day
    Richard Antonelli
    Harold Pincus



    Day 3: May 25, 2017  
    8:30 AM   Breakfast
    9:00 AM   Welcome Back
    Richard Antonelli
  • Review the day’s objectives
  • Share relevant highlights from previous day


  • 9:15 AM   Overview of Meeting Materials and Key Points from Staff Review of Core Set
    May Nacion, Project Manager, NQF
  • What do we know about states’ uptake of measures?
  • What do we know about states’ performance on measures?
  • Patterns apparent in technical assistance requests
  • Core set measure updates (maintenance, loss of endorsement, new endorsement)


  • 9:45 AM   CMS/State Perspectives Panel
    Laurie Norris JD, CMS Senior Policy Advisor for Oral Health Initiative


    10:00 AM   CMS/State Perspectives Panel
    Lindsay Cogan, PhD, MS, Director, Quality Measurement and Evaluation Unit, New York State Department of Health


    10:40 AM   Break
    10:55 AM   Measure-Specific Recommendations on Strengthening the Child Core Set
    Richard Antonelli
    Shaconna Gorham
  • Examine measures with low reporting uptake
  • Feasibility of states collecting and reporting the measure
  • Review and select measures to fill gap areas


  • 12:25 PM   Opportunity for Public Comment
    12:35 PM   Lunch
    1:05 PM   Continue Measure-Specific Recommendations on Strengthening the Child Core Set
    Richard Antonelli
    Shaconna Gorham
  • PQMP Measure Development and Endorsement
  • Continue to review and select measures to fill gap areas
  • Rank new measures selected for potential addition to the set


  • 2:35 PM   Opportunity for Public Comment and Break
    3:00 PM   Prioritizing Remaining Measure Gap Areas
    Richard Antonelli
    Debjani Mukherjee
  • Set the stage for MAP’s next review and/or guide development efforts
  • Future opportunities to fill gap areas such as measure concepts


  • 3:50 PM   Opportunity for Public Comment
    4:00 PM   Summarize Next Steps and Adjourn Meeting
    Richard Antonelli


    Measures Recommended by Task Force Members   Gap Area: Care coordination
    Measures for Discussion and Voting
    1. NQF #2842: Family Experiences with Coordination of Care (FECC)-1 Has Care Coordinator
      • Description: The Family Experiences with Coordination of Care (FECC) Survey was developed to gather information about the quality of care coordination being received by children with medical complexity (CMC) over the previous 12 months. The FECC Survey is completed by English- and Spanish-speaking caregivers of CMC aged 0-17 years with at least 4 medical visits in the previous year, and it includes all of the information needed to score 20 separate and independent quality measures, a sub-set of 8 of which are included in this submitted measure set. CMC are identified from administrative data using the Pediatric Medical Complexity Algorithm (PMCA)1, which uses up to 3 years’ worth of International Classification of Diseases—9th Revision (ICD-9) codes to classify a child’s illness with regard to chronicity and complexity. CMC are children identified by the PMCA as having complex, chronic disease. The full NQF submission includes a set of 8 of the FECC quality measures; this submission relates to FECC 1, described below. The short descriptions of each quality measure follows; full details of FECC-1 are provided in the Detailed Measure Specifications (see S.2b):2842: FECC-1: Has care coordinator2843: FECC-3: Care coordinator helped to obtain community services2844: FECC-5: Care coordinator asked about concerns and health changes2845: FECC-7: Care coordinator assisted with specialist service referrals2846: FECC-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs2847: FECC-9: Appropriate written visit summary content2849: FECC-15: Caregiver has access to medical interpreter when needed2850: FECC-16: Child has shared care planEach of the quality measures is scored on a 0-100 scale, with higher scores indicating better care. For dichotomous measures, a score of 100 indicates the child received the recommended care; a score of 0 indicates that they did not. Please see Detailed Measure Specifications (see S.2b) for additional measure-specific scoring information. (Measure Specifications; Summary of NQF Endorsement Review)


    2. NQF #2843: Family Experiences with Coordination of Care (FECC) -3: Care coordinator helped to obtain community services
      • Description: The Family Experiences with Coordination of Care (FECC) Survey was developed to gather information about the quality of care coordination being received by children with medical complexity (CMC) over the previous 12 months. The FECC Survey is completed by English- and Spanish-speaking caregivers of CMC aged 0-17 years with at least 4 medical visits in the previous year, and it includes all of the information needed to score 20 separate and independent quality measures, a sub-set of 8 of which are included in this submitted measure set. CMC are identified from administrative data using the Pediatric Medical Complexity Algorithm (PMCA)1, which uses up to 3 years’ worth of International Classification of Diseases—9th Revision (ICD-9) codes to classify a child’s illness with regard to chronicity and complexity. CMC are children identified by the PMCA as having complex, chronic disease. The full NQF submission includes a set of 8 of the FECC quality measures; this submission relates to FECC 3, described below. The short descriptions of each quality measure follows; full details are provided in the Detailed Measure Specifications (see S.2b):2842: FECC-1: Has care coordinator2843: FECC-3: Care coordinator helped to obtain community services2844: FECC-5: Care coordinator asked about concerns and health changes2845: FECC-7: Care coordinator assisted with specialist service referrals2846: FECC-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs2847: FECC-9: Appropriate written visit summary content2849: FECC-15: Caregiver has access to medical interpreter when needed2850: FECC-16: Child has shared care planEach of the quality measures is scored on a 0-100 scale, with higher scores indicating better care. For dichotomous measures, a score of 100 indicates the child received the recommended care; a score of 0 indicates that they did not. Please see Detailed Measure Specifications (see S.2b) for additional measure-specific scoring information. (Measure Specifications; Summary of NQF Endorsement Review)


    3. NQF #2844: Family Experiences with Coordination of Care (FECC) -5: Care coordinator asked about concerns and health
      • Description: The Family Experiences with Coordination of Care (FECC) Survey was developed to gather information about the quality of care coordination being received by children with medical complexity (CMC) over the previous 12 months. The FECC Survey is completed by English- and Spanish-speaking caregivers of CMC aged 0-17 years with at least 4 medical visits in the previous year, and it includes all of the information needed to score 20 separate and independent quality measures, a sub-set of 8 of which are included in this submitted measure set. CMC are identified from administrative data using the Pediatric Medical Complexity Algorithm (PMCA)1, which uses up to 3 years’ worth of International Classification of Diseases—9th Revision (ICD-9) codes to classify a child’s illness with regard to chronicity and complexity. CMC are children identified by the PMCA as having complex, chronic disease. The full NQF submission includes a set of 8 of the FECC quality measures; this submission relates to FECC 5, described below. The short descriptions of each quality measure follows; full details are provided in the Detailed Measure Specifications (see S.2b):2842: FECC-1: Has care coordinator2843: FECC-3: Care coordinator helped to obtain community services2844: FECC-5: Care coordinator asked about concerns and health changes2845: FECC-7: Care coordinator assisted with specialist service referrals2846: FECC-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs2847: FECC-9: Appropriate written visit summary content2849: FECC-15: Caregiver has access to medical interpreter when needed2850: FECC-16: Child has shared care planEach of the quality measures is scored on a 0-100 scale, with higher scores indicating better care. For dichotomous measures, a score of 100 indicates the child received the recommended care; a score of 0 indicates that they did not. Please see Detailed Measure Specifications (see S.2b) for additional measure-specific scoring information. (Measure Specifications; Summary of NQF Endorsement Review)


    4. NQF #2845: Family Experiences with Coordination of Care (FECC) -7: Care coordinator assisted with specialist service referrals
      • Description: The Family Experiences with Coordination of Care (FECC) Survey was developed to gather information about the quality of care coordination being received by children with medical complexity (CMC) over the previous 12 months. The FECC Survey is completed by English- and Spanish-speaking caregivers of CMC aged 0-17 years with at least 4 medical visits in the previous year, and it includes all of the information needed to score 20 separate and independent quality measures, a sub-set of 8 of which are included in this submitted measure set. CMC are identified from administrative data using the Pediatric Medical Complexity Algorithm (PMCA)1, which uses up to 3 years’ worth of International Classification of Diseases—9th Revision (ICD-9) codes to classify a child’s illness with regard to chronicity and complexity. CMC are children identified by the PMCA as having complex, chronic disease. The full NQF submission includes a set of 8 of the FECC quality measures; this submission relates to FECC 7, described below. The short descriptions of each quality measure follows; full details are provided in the Detailed Measure Specifications (see S.2b):2842: FECC-1: Has care coordinator2843: FECC-3: Care coordinator helped to obtain community services2844: FECC-5: Care coordinator asked about concerns and health changes2845: FECC-7: Care coordinator assisted with specialist service referrals2846: FECC-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs2847: FECC-9: Appropriate written visit summary content2849: FECC-15: Caregiver has access to medical interpreter when needed2850: FECC-16: Child has shared care planEach of the quality measures is scored on a 0-100 scale, with higher scores indicating better care. For dichotomous measures, a score of 100 indicates the child received the recommended care; a score of 0 indicates that they did not. Please see Detailed Measure Specifications (see S.2b) for additional measure-specific scoring information. (Measure Specifications; Summary of NQF Endorsement Review)


    5. NQF #2846: Family Experiences with Coordination of Care (FECC)-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs
      • Description: The Family Experiences with Coordination of Care (FECC) Survey was developed to gather information about the quality of care coordination being received by children with medical complexity (CMC) over the previous 12 months. The FECC Survey is completed by English- and Spanish-speaking caregivers of CMC aged 0-17 years with at least 4 medical visits in the previous year, and it includes all of the information needed to score 20 separate and independent quality measures, a sub-set of 8 of which are included in this submitted measure set. CMC are identified from administrative data using the Pediatric Medical Complexity Algorithm (PMCA)1, which uses up to 3 years’ worth of International Classification of Diseases—9th Revision (ICD-9) codes to classify a child’s illness with regard to chronicity and complexity. CMC are children identified by the PMCA as having complex, chronic disease. The full NQF submission includes a set of 8 of the FECC quality measures; this submission relates to FECC 8, described below. The short descriptions of each quality measure follows; full details for FECC-8 are provided in the Detailed Measure Specifications (see S.2b):2842: FECC-1: Has care coordinator2843: FECC-3: Care coordinator helped to obtain community services2844: FECC-5: Care coordinator asked about concerns and health changes2845: FECC-7: Care coordinator assisted with specialist service referrals2846: FECC-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs2847: FECC-9: Appropriate written visit summary content2849: FECC-15: Caregiver has access to medical interpreter when needed2850: FECC-16: Child has shared care planEach of the quality measures is scored on a 0-100 scale, with higher scores indicating better care. For dichotomous measures, a score of 100 indicates the child received the recommended care; a score of 0 indicates that they did not. Please see Detailed Measure Specifications (see S.2b) for additional measure-specific scoring information. (Measure Specifications; Summary of NQF Endorsement Review)


    6. NQF #2847: Family Experiences with Coordination of Care (FECC) -9: Appropriate written visit summary content
      • Description: The Family Experiences with Coordination of Care (FECC) Survey was developed to gather information about the quality of care coordination being received by children with medical complexity (CMC) over the previous 12 months. The FECC Survey is completed by English- and Spanish-speaking caregivers of CMC aged 0-17 years with at least 4 medical visits in the previous year, and it includes all of the information needed to score 20 separate and independent quality measures, a sub-set of 8 of which are included in this submitted measure set. CMC are identified from administrative data using the Pediatric Medical Complexity Algorithm (PMCA)1, which uses up to 3 years’ worth of International Classification of Diseases—9th Revision (ICD-9) codes to classify a child’s illness with regard to chronicity and complexity. CMC are children identified by the PMCA as having complex, chronic disease. The full NQF submission includes a set of 8 of the FECC quality measures; this submission relates to FECC 9, described below. The short descriptions of each quality measure follows; full details for FECC-9 are provided in the Detailed Measure Specifications (see S.2b):2842: FECC-1: Has care coordinator2843: FECC-3: Care coordinator helped to obtain community services2844: FECC-5: Care coordinator asked about concerns and health changes2845: FECC-7: Care coordinator assisted with specialist service referrals2846: FECC-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs2847: FECC-9: Appropriate written visit summary content2849: FECC-15: Caregiver has access to medical interpreter when needed2850: FECC-16: Child has shared care planEach of the quality measures is scored on a 0-100 scale, with higher scores indicating better care. For dichotomous measures, a score of 100 indicates the child received the recommended care; a score of 0 indicates that they did not. Please see Detailed Measure Specifications (see S.2b) for additional measure-specific scoring information. (Measure Specifications; Summary of NQF Endorsement Review)


    7. NQF #2849: Family Experiences with Coordination of Care (FECC)-15: Caregiver has access to medical interpreter when needed
      • Description: The Family Experiences with Coordination of Care (FECC) Survey was developed to gather information about the quality of care coordination being received by children with medical complexity (CMC) over the previous 12 months. The FECC Survey is completed by English- and Spanish-speaking caregivers of CMC aged 0-17 years with at least 4 medical visits in the previous year, and it includes all of the information needed to score 20 separate and independent quality measures, a sub-set of 8 of which are included in this submitted measure set. CMC are identified from administrative data using the Pediatric Medical Complexity Algorithm (PMCA)1, which uses up to 3 years’ worth of International Classification of Diseases—9th Revision (ICD-9) codes to classify a child’s illness with regard to chronicity and complexity. CMC are children identified by the PMCA as having complex, chronic disease. The full NQF submission includes a set of 8 of the FECC quality measures; this submission relates to FECC 15, described below. The short descriptions of each quality measure follows; full details for FECC-15 are provided in the Detailed Measure Specifications (see S.2b):2842: FECC-1: Has care coordinator2843: FECC-3: Care coordinator helped to obtain community services2844: FECC-5: Care coordinator asked about concerns and health changes2845: FECC-7: Care coordinator assisted with specialist service referrals2846: FECC-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs2847: FECC-9: Appropriate written visit summary content2849: FECC-15: Caregiver has access to medical interpreter when needed2850: FECC-16: Child has shared care planEach of the quality measures is scored on a 0-100 scale, with higher scores indicating better care. For dichotomous measures, a score of 100 indicates the child received the recommended care; a score of 0 indicates that they did not. Please see Detailed Measure Specifications (see S.2b) for additional measure-specific scoring information. (Measure Specifications; Summary of NQF Endorsement Review)


    8. NQF #2850: Family Experiences with Coordination of Care (FECC)-16: Child has shared care plan
      • Description: The Family Experiences with Coordination of Care (FECC) Survey was developed to gather information about the quality of care coordination being received by children with medical complexity (CMC) over the previous 12 months. The FECC Survey is completed by English- and Spanish-speaking caregivers of CMC aged 0-17 years with at least 4 medical visits in the previous year, and it includes all of the information needed to score 20 separate and independent quality measures, a sub-set of 8 of which are included in this submitted measure set. CMC are identified from administrative data using the Pediatric Medical Complexity Algorithm (PMCA)1, which uses up to 3 years’ worth of International Classification of Diseases—9th Revision (ICD-9) codes to classify a child’s illness with regard to chronicity and complexity. CMC are children identified by the PMCA as having complex, chronic disease. The full NQF submission includes a set of 8 of the FECC quality measures; this submission relates to FECC 16, described below. The short descriptions of each quality measure follows; full details for FECC-16 are provided in the Detailed Measure Specifications (see S.2b):2842: FECC-1: Has care coordinator2843: FECC-3: Care coordinator helped to obtain community services2844: FECC-5: Care coordinator asked about concerns and health changes2845: FECC-7: Care coordinator assisted with specialist service referrals2846: FECC-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs2847: FECC-9: Appropriate written visit summary content2849: FECC-15: Caregiver has access to medical interpreter when needed2850: FECC-16: Child has shared care planEach of the quality measures is scored on a 0-100 scale, with higher scores indicating better care. For dichotomous measures, a score of 100 indicates the child received the recommended care; a score of 0 indicates that they did not. Please see Detailed Measure Specifications (see S.2b) for additional measure-specific scoring information. (Measure Specifications; Summary of NQF Endorsement Review)


    9. NQF #1659: Influenza Immunization
      • Description: Measure Description: Inpatients age 6 months and older discharged during October, November, December, January, February or March who are screened for influenza vaccine status and vaccinated prior to discharge if indicated. (Measure Specifications; Summary of NQF Endorsement Review)


    10. NQF #3154: Informed Coverage
      • Description: Brief Description of Measure: Improved measurement of the continuity of insurance coverage in the Medicaid and CHIP population is needed to help maximize insurance continuity and coverage for vulnerable children. To further this goal, the AHRQ-CMS CHIPRA PQMP Center of Excellence at the Children’s Hospital of Philadelphia developed the metric Informed Coverage. The metric is designed to more accurately measure coverage among children enrolled in Medicaid or CHIP at the state level and overcome the current inability in the Medicaid Analytic eXtract (MAX) dataset to determine whether a child disenrolled from Medicaid and CHIP due to loss of eligibility (such as due to parental income increase or the acquisition of employer-sponsored insurance, a “good” reason) or failure to appropriately re-enroll (a “bad” reason). This measure can help federal and state programs develop strategies to retain children eligible for coverage and minimize gaps that can occur during the renewal process. Informed Coverage assesses the continuity of enrollment of children in publicly financed insurance programs (Medicaid and CHIP), as defined by the ratio of enrolled month to eligible months over an 18 month observation window. Informed Coverage uses a natural experiment based on the random event of appendicitis to “inform” the estimate of coverage in a given state, bounded by two extreme assumptions regarding unknown eligibility (Measure Specifications; Summary of NQF Endorsement Review)


    Gap Area: Cost measures
    Measures for Discussion and Voting
    1. Emergency Department Visits - Potentially Treatable in Primary Care

    Gap Area: Mental health
    Measures for Discussion and Voting
    1. NQF #2800: Metabolic Monitoring for Children and Adolescents on Antipsychotics

    Gap Area: Sickle cell disease
    Measures for Discussion and Voting
    1. NQF #3166: Antibiotic Prophylaxis for Patients with Sickle Cell Anemia


    Appendix A: Measure Information

    Measure Index

    Care coordination

    Cost measures

    Asthma

    Mental health

    Maternal and Reproductive Health

    Sickle cell disease


    Full Measure Information

    NQF #1659: Influenza Immunization (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2842: Family Experiences with Coordination of Care (FECC)-1 Has Care Coordinator (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2843: Family Experiences with Coordination of Care (FECC) -3: Care coordinator helped to obtain community services (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2844: Family Experiences with Coordination of Care (FECC) -5: Care coordinator asked about concerns and health (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2845: Family Experiences with Coordination of Care (FECC) -7: Care coordinator assisted with specialist service referrals (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2846: Family Experiences with Coordination of Care (FECC)-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2847: Family Experiences with Coordination of Care (FECC) -9: Appropriate written visit summary content (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2849: Family Experiences with Coordination of Care (FECC)-15: Caregiver has access to medical interpreter when needed (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2850: Family Experiences with Coordination of Care (FECC)-16: Child has shared care plan (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #3154: Informed Coverage (Gap Area: Care coordination)

    Measure Specifications

    Summary of NQF Endorsement Review




    Emergency Department Visits - Potentially Treatable in Primary Care (Gap Area: Cost measures)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #1800: Asthma Medication Ratio (AMR) (Gap Area: Asthma)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2800: Metabolic Monitoring for Children and Adolescents on Antipsychotics (Gap Area: Mental health)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #0480 PC-05 Exclusive Breast Milk Feeding (Gap Area: Maternal and Reproductive Health)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2830 PC-05 Exclusive Breast Milk Feeding (Gap Area: Maternal and Reproductive Health)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #2903: Contraceptive Care -- Most and Moderately Effective Methods (Gap Area: Maternal and Reproductive Health)

    Measure Specifications

    Summary of NQF Endorsement Review




    NQF #3166: Antibiotic Prophylaxis for Patients with Sickle Cell Anemia (Gap Area: Sickle cell disease)

    Measure Specifications

    Summary of NQF Endorsement Review





    Appendix B: Gap Areas Identified by Child Task Force in 2016

    Gap Areas marked with an asterisk do not have any Task Force recommended measures.

    Gap Area Index



    Appendix C: Public Comments


    Web Meeting Comments

    The American College of Obstetricians and Gynecologists (ACOG) (Gap Area: Maternal and Reproductive Health)

    Appendix D: Instructions and Help

    If you have any problems navigating the discussion guide, please contact us at: mapmedicaidchild@qualityforum.org

    Navigating the Discussion Guide

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