CMS Finalizes Set of 35 Core Quality Measures for the Care of Medicaid-Eligible Adults | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

CMS Finalizes Set of 35 Core Quality Measures for the Care of Medicaid-Eligible Adults

January 6, 2012
by Mark Hagland
| Reprints
Federal government works to standardize quality measurement across programs

On January 4, the federal Centers for Medicare and Medicaid Services (CMS) announced, through publication in the Federal Register, an Initial Core Set of Health Care Quality measures for Medicaid-Eligible Adults, in compliance with a provision in the federal Affordable Care Act (ACA) of 2010. The set of 35 measures was created for voluntary use by state programs administered under Title XIX of the Social Security Act, health insurers that enter into contracts with state Medicaid programs, and providers of items and services under those programs.

The CMS notice stated that “Identification of the initial core set of measures for Medicaid-eligible adults is an important first step in an overall strategy to encourage and enhance quality improvement. States that choose to collect the initial core set will be better positioned to measure their performance and develop action plans to achieve the three-part aims of better care, healthier people, and affordable care as identified in HHS’s Strategy for Quality Improvement in Health Care.

“The initial core set of quality measures for voluntary annual reporting,” the notice added,” has been determined based on recommendations from the Agency for Healthcare Research and Quality’s Subcommittee to the National Advisory council for Healthcare Research and Quality, as well as public comments, before being finalized by the Secretary [Kathleen Sebelius]. These core set measures will support HHS and its state partners in developing a quality-driven, evidence-based, national system for measuring the quality of healthcare provided to Medicaid-eligible adults.”

Among the 35 measures are the following:

> “Flu shots for adults ages 50-64”
> “Adult BMI [body mass index] assessment"
> “Plan all-cause readmission”
> “Diabetes, short-term complications admission rate”
> “Chronic obstructive pulmonary disease (COPD) admission rate”
> “Congestive heart failure admission rate”
> “Follow-up after hospitalization for mental illness”
> “Comprehensive diabetes care: hemoglobin A1c testing”
> “Antidepressant medication management”
> “Adherence to antipsychotic for individuals with schizophrenia”
> “Care transition—transition record transmitted to health care professional”

The federal notice also stated that “The initial core set will be used by states to assess the quality of healthcare provided in their Medicaid programs for adults (ages 18 years and older) and across all healthcare delivery systems (for example, fee-for-service, managed care, primary care management)> We understand that some of the measures are currently specified only for a particular delivery system (for example, managed care),” the notice said. “However, additional guidance will be provided to states so that these measures can be used across delivery systems, and Medicaid-funded programs targeting adults, including long-term services and supports.”

The Medicaid Adult Quality Measures Program will be rolled out throughout the year, with CMS expected to release technical specifications by September.

 

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Geisinger National Precision Health Hires Illumina Exec to Lead Business Development

Integrated health system Geisinger has hired a high-profile genetic counselor to head up business development for Geisinger National Precision Health, which was created to extend the Geisinger model on the national scene.

$30M VC Fund Launched to Spur Innovation in Cardiovascular Care

The American Heart Association, together with Philips and UPMC, has announced the launch of Cardeation Capital, a $30 million collaborative venture capital fund designed to spur healthcare innovation in heart disease and stroke care.

Epic Wins Labor Dispute in Closely Divided Supreme Court Decision

Epic Systems Corporation won a major labor-law ruling in the Supreme Court on Monday, centering around the extent of corporations’ right to force employees to sign arbitration agreements, and with a 5-4 ruling in its favor

Survey: Two-Thirds of Physician Practices Seeking Out Value-Based Care Consulting Firms

Most physician organizations are not prepared for the move to value-based care, and 95 percent CIOs of group practices and large clinics state they do not have the information technology or staff in-house needed to transform value-based care end-to-end, according to a recent Black Book Market Research.

Cumberland Consulting Buys LinkEHR, Provider of Epic Help Desk Services

Cumberland Consulting Group, a healthcare consulting and services firm, has acquired LinkEHR, which provides remote application support, including Epic help desk services.

Population Health Tool that Provides City-Level Data Expands to 500 Cities

A data visualization tool that helps city officials understand the health status of their population, called the City Health Dashboard, has now expanded to 500 of the largest cities in the U.S., enabling local leaders to identify and take action around the most pressing health needs in their cities and communities.