Medicaid Program: Initial Core Set of Health Care Quality Measures for Medicaid-Eligible Adults, 286-291 [2011-33756]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Office of the Secretary

[Federal Register Volume 77, Number 2 (Wednesday, January 4, 2012)]
[Notices]
[Pages 286-291]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-33756]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

[CMS-2420-FN]


Medicaid Program: Initial Core Set of Health Care Quality 
Measures for Medicaid-Eligible Adults

AGENCY: Office of the Secretary, HHS.

ACTION: Final notice.

-----------------------------------------------------------------------

SUMMARY: This final notice announces the initial core set of health 
care quality measures for Medicaid-eligible adults, as required by 
section 2701 of the Affordable Care Act, for voluntary use by State 
programs administered under title XIX of the Social Security Act, 
health insurance issuers and managed care entities that enter into 
contracts with Medicaid, and providers of items and services under 
these programs.

FOR FURTHER INFORMATION CONTACT: Karen Llanos, Centers for Medicare & 
Medicaid Services, (410) 786-9071.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 2701 of the Patient Protection and Affordable Care Act 
(Affordable Care Act) (Pub. L. 111-148) added new section 1139B to the 
Social Security Act (the Act). Section 1139B(a) of the Act directs the 
Secretary of Health and Human Services (HHS) to identify and publish 
for public comment a recommended initial core set of health care 
quality measures for Medicaid-eligible adults, and section 1139B(b)(1) 
of the Act requires that an initial core set be published by January 1, 
2012. Additionally, the statute requires the initial core set 
recommendation to consist of existing adult health care quality 
measures in use under public and privately sponsored health care 
coverage arrangements or that are part of reporting systems that 
measure both the presence and duration of health insurance coverage 
over time and that may be applicable to Medicaid-eligible adults.
    Section 1139B of the Act also requires the Secretary to complete 
the following actions:

--By January 1, 2012:

     Establish a Medicaid Quality Measurement Program to fund 
development, testing, and validation of emerging and innovative 
evidence-based measures.

--By January 1, 2013:

     Develop a standardized reporting format for the core set 
of adult quality measures and procedures to encourage voluntary 
reporting by the States.

--By January 1, 2014:
     Annually publish recommended changes to the initial core 
set that shall reflect the results of the testing, validation, and 
consensus process for the development of adult health quality measures.
     Include in the report to Congress mandated under section 
1139A(a)(6) of the Act on the quality of health care of children in 
Medicaid and the Children's Health Insurance Program (CHIP) similar 
information for adult health quality with respect to measures 
established under section 1139B of the Act. This report must be 
published every 3 years thereafter in accordance with the statute.

--By September 30, 2014:
     Collect, analyze, and make publicly available the 
information reported by the States as required in section 1139B(d)(1) 
of the Act.
    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 chose 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' National Strategy for Quality Improvement in Health Care. 
Additional information about the National Quality Strategy can be found 
at: https://www.ahrq.gov/workingforquality/nqs/.
    The initial core set of quality measures for voluntary annual 
reporting by States 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. 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 health care provided to Medicaid-eligible adults.
    Over the next year, CMS will phase in components of the Medicaid 
Adult Quality Measures Program that will help to further identify 
measurement gap areas and begin testing the collection of some of the 
initial core measures. The Medicaid Adult Quality Measures Program will 
focus on developing and refining measures, where needed, so that future 
updates to the initial core set can meet a wider range of States' 
health care quality measurement needs. By September 2012, CMS will 
release technical specifications as a resource for States that seek to 
voluntarily collect and report the initial core set of health care 
quality measures for Medicaid-eligible adults. Additionally, as 
required in statute, by January 1, 2013, CMS will issue guidance for 
submitting the initial core set to CMS in a standardized format. 
Lastly, much like activities conducted under section 1139A of the Act 
for the initial core child health care quality measures, the Secretary 
will launch a Technical Assistance and Analytic Support Program to help 
States collect, report, and use the voluntary core set of adult 
measures.

II. Method for Determining the Initial Set of Health Care Quality 
Measures for Medicaid-Eligible Adults

    The Affordable Care Act requires the development of a core set of 
health quality measures for adults eligible for benefits under 
Medicaid. The statute parallels the requirement under section 1139A of 
the Act to identify and publish a recommended initial core set of 
quality measures for children in Medicaid and the CHIP. HHS used a 
similar process to identify the initial set of health care quality 
measures for Medicaid-eligible adults.
    The Centers for Medicare & Medicaid Services (CMS) partnered with 
the Agency for Healthcare Research and Quality (AHRQ) to collaborate on 
the identification of the initial core set of health care quality 
measures for adults. Working through its National Advisory Council for 
Healthcare Research and Quality, which provides advice and 
recommendations to the Director of AHRQ and to the Secretary of HHS on 
priorities for a national health services research agenda, AHRQ created 
a Subcommittee in the fall of 2010 to evaluate candidate measures for 
the initial core set. The Subcommittee consisted of State Medicaid 
representatives, health care quality experts, and representatives of 
health professional organizations and associations, and was charged 
with considering the health care quality needs of adults (ages 18 and 
older) enrolled in Medicaid in its

[[Page 287]]

recommendation for an initial core set of measures to HHS. The 
Subcommittee reviewed and evaluated measures from nationally recognized 
sources, including measures endorsed by the National Quality Forum 
(NQF), measures submitted by Medicaid medical directors, measures 
currently in use by CMS, and measures suggested by the Co-chairs and 
members of the Subcommittee. Starting from approximately 1,000 
measures, a total of 51 measures were recommended and posted for public 
comment. A report detailing the initial convening of the Subcommittee 
may be found on the AHRQ Web site: https://www.ahrq.gov/about/nacqm/.
    The measures were posted for public comment through a Federal 
Register (75 FR 82397) notice published on December 30, 2010, with 
comments due by March 1, 2011. The public submitted 100 comments. 
Public comments suggested concern about the large size of the proposed 
set, with many requesting alignment to the extent possible with 
existing Federal initiatives. An additional 43 measures were suggested 
through public comment. See discussion in section III of this final 
notice for a more detailed discussion.
    To be responsive to the public comments, the Subcommittee sought to 
identify measures that ensured comprehensive representation of 
variables affecting Medicaid-eligible adults while considering ways to 
decrease the number of measures in the set. AHRQ and CMS identified 
five criteria against which to evaluate the proposed core measures: 
importance; scientific evidence supporting the measure; scientific 
soundness of the measure; current use in and alignment with existing 
Federal programs; and feasibility for State reporting (a background 
report detailing the selection criteria and Subcommittee process can be 
found at: https://www.ahrq.gov). The criteria represented attributes 
desired of State-level measures that would represent Medicaid-eligible 
adults. In particular, those criteria regarding current use in and 
alignment with existing Federal programs and feasibility for State 
reporting were given particular emphasis, since those were attributes 
identified repeatedly in the public comments. Documented use of or 
alignment with existing Federal programs such as the National Quality 
Strategy's six priorities, the Medicare and Medicaid Electronic Health 
Record (EHR) Incentive Programs, and Physician Quality Reporting was 
taken into consideration as the Subcommittee reviewed each measure.
    As in the initial meeting, the Subcommittee broke into workgroups 
focusing on four dimensions of health care related to adults in 
Medicaid: Adult Health, Maternal/Reproductive Health, Complex Health 
Care Needs, and Mental Health and Substance Use. Workgroups were 
assigned two sets of measures that related to their specific areas: 
originally recommended measures and measures proposed in public 
comment. To assess how each measure fared against the five criteria, 
the Subcommittee reviewed background information (including numerator, 
denominator, exclusions, prevalence, clinical guidelines, past 
performance rates, etc.) on each measure from the measure owners, 
developers, or stewards.

A. Adult Health

    The workgroup prioritized 10 of the original measures to be 
included in the final set, dropping five measures that were duplicative 
of other measures. The workgroup brought forward one measure that was 
suggested in public comment, Adult Body Mass Index (BMI) Assessment, 
replacing a similar BMI measure that had been originally recommended 
for the core set, Preventive Care and Screening: BMI Screening and 
Follow-Up. The workgroup did not recommend including the remaining 16 
newly suggested measures received from the public comment period.

B. Maternal/Reproductive Health

    After evaluating the measures against the criteria, the Maternal/
Reproductive Health workgroup recommended keeping each of the five 
measures originally posed for the core set, noting that these measures 
addressed areas of high importance to women and reproductive health, 
were feasible to report and aligned well with current programs 
(including the initial core set of children's health care quality 
measures \1\). The workgroup noted that, while future measures should 
tie screenings to outcomes and assess additional issues outside of 
pregnancy that affect women (for example, access to care, incontinence 
due to multiple pregnancies), the measures being recommended for the 
core set were an important first step of using performance measures for 
quality improvement. Of the measures newly suggested through public 
comment, the workgroup recommended bringing one measure forward to a 
Subcommittee vote: Chlamydia Screening in Women. The workgroup rated 
this measure high on each criterion and noted its alignment with the 
initial core set of children's health care quality measures (the 
initial core set of children's measures specified only the lower age 
group of this measure; adding the higher age range means the measure 
now would be reported in full).
---------------------------------------------------------------------------

    \1\ Initial Core Set of Children's Health Care Quality Measures 
https://www.cms.gov/MedicaidCHIPQualPrac/Downloads/CHIPRACoreSetTechManual.pdf.
---------------------------------------------------------------------------

C. Complex Health Care Needs

    The Complex Health Care Needs workgroup recommended nine of the 18 
measures originally posed for inclusion in the draft core set. Although 
the topic areas represented in the measures suggested through public 
comment were important to Medicaid, many of the measures scored low on 
multiple criteria (for example, scientific soundness and feasibility 
for State reporting) and thus were deemed not ready for wide-scale 
implementation. Further, although several of the proposed measures 
assessed the very important topic of care coordination for patients who 
are hospitalized or transferred across multiple facilities, the 
workgroup noted that many of these measures were challenged by complex 
requirements for data collection and excluded target populations (for 
example, dually eligible beneficiaries and individuals with long-term 
care services and supports needs). Many of the measures, for example, 
required medical record review across time or at more than one site 
(for example, Change in Basic Mobility as Measured by the AM-PAC and 
Medication Reconciliation Post-Discharge). The workgroup concluded that 
the remaining measures suggested in public comment, though relevant to 
people with complex health care needs, addressed very narrow clinical 
conditions, excluded key populations, were difficult to collect at the 
State level, or were duplicative of other, more highly-rated measures.

D. Mental Health and Substance Use

    After discussing how well the 13 measures originally proposed fared 
against the selection criteria, the Mental Health and Substance Use 
workgroup recommended nine measures for inclusion in the draft core set 
and decided against bringing forward any of the additional measures 
suggested in public comment. In general, the workgroup prioritized 
measures that were broadly applicable to the Medicaid population or to 
primary care settings. For example, the workgroup included measures 
that assessed conditions that may be prevalent in a low-income 
population, including depression, schizophrenia, and substance use, in

[[Page 288]]

addition to measures that assessed utilization of general mental health 
services. The workgroup did not recommend including any of the five 
measures suggested in public comment, as they concluded that these 
measures addressed similar content areas as other higher-rated measures 
or were rated very low in feasibility for State collection and 
reporting.

E. Summary

    A total of 35 measures received a majority vote from the full 
Subcommittee. The measures voted upon by the Subcommittee included 
recommendations from each workgroup that were based on the original 51 
measures as well as new measures identified through public comment that 
were brought forth by each workgroup. The Adult Health work group 
recommended eleven measures for inclusion in the initial core set. The 
Maternal/Reproductive Health work group recommended six measures. The 
Complex Health Care Needs work group recommended nine measures and the 
Mental Health and Substance Use recommended nine measures.
    The Subcommittee discussed how these measures represented 
conditions and populations relevant to Medicaid, and examined each 
measure's data source and use in existing programs. In the final round 
of voting, 24 \2\ measures ultimately received a majority vote by 
Subcommittee members. In order to ensure priority populations were 
fully represented and that the goals of planned initiatives could be 
monitored, we then added two measures originally proposed for the draft 
core set (PC-01 Elective Delivery and Timely Transmission of Transition 
Record). The Subcommittee deferred the decision to CMS and AHRQ on 
which of the two HIV-related measures under consideration (HIV/AIDS 
Screening: Members at High Risk of HIV/AIDS and HIV/AIDS: Medical 
Visits) would be included in the core set. Upon discussion with 
colleagues from the Centers for Disease Control and Prevention and the 
Health Resources and Services Administration, the decision was made to 
include the measure originally proposed for the core set, HIV/AIDS: 
Medical Visit. A total of 26 are included in the initial core set.
---------------------------------------------------------------------------

    \2\ The CAHPS Health Plan Survey v 4.0--Adult Questionnaire and 
the CAHPS Health Plan Survey v 4.0H--NCQA Supplemental Items for 
CAHPS are counted as one measure.
---------------------------------------------------------------------------

III. Analysis of and Responses to Public Comments on the Notice of 
Comment Period

    In response to the publication of the December 30, 2010 notice with 
comment period, we received 100 timely public comments. The following 
are a summary of the public comments that we received related to that 
notice, and our responses to the comments:
    Comment: About a third of the comments specifically noted that the 
draft core set published in the Federal Register on December 30, 2010, 
was too large or raised the burden of reporting by States as a concern. 
Commenters also suggested reducing the measures to two measures per 
category or considering a phase-in approach.
    Response: To address these concerns, the size of the core set was 
reduced by almost half (from 51 measures in the draft core set to 26 
measures in the initial core set). Although the numbers of measures was 
reduced, we believe that this initial core set still reflects the 
health care needs of Medicaid-eligible adults. In addition to reducing 
the size of the initial core set, to support States in collecting and 
reporting these measures, CMS will provide technical assistance as well 
as additional guidance and tools to increase the feasibility of 
voluntary reporting.
    Comment: Numerous comments suggested avoiding measures for 
inclusion in the initial core set that require medical record review.
    Response: To the degree possible, measures that require medical 
record review were excluded in large-scale from the initial core set. 
However, in order to address aspects of health care quality important 
to the adult Medicaid population and to align with existing measurement 
programs (for example, the Medicare & Medicaid EHR Incentive Programs) 
a few measures that require medical record review (for example, 
controlling high blood pressure) were included in the initial core set.
    Comment: Many comments suggested aligning measures with existing 
reporting programs, such as the Medicare and Medicaid EHR Incentive 
Programs and the Inpatient Hospital Quality Reporting program, as a way 
to decrease burden.
    Response: We agree with these comments. To the degree possible, the 
initial core set aligns with existing Federal reporting programs. 
Seventeen measures from the initial core set are used in other CMS 
programs (refer to table at the end of Notice). Alignment was a key 
criterion employed in the review, based in part, on the strength of 
related public comments. At the same time, the areas addressed by the 
measures in the initial core set, however, must reflect the 
requirements of the statute to provide an overall assessment of the 
quality of care received by adults in Medicaid. As such, the types of 
quality measures included in other reporting programs may not fully 
represent the health care measurement needs of Medicaid-eligible 
adults.
    Comment: Several commenters suggested using only measures endorsed 
by the National Quality Forum or National Committee for Quality 
Assurance Health Employer Data and Information Set (HEDIS[supreg]) 
measures. Many comments also emphasized the importance of ensuring the 
initial core set measures met thresholds for evidence, validity, 
reliability and feasibility.
    Response: A key priority used in selecting the initial core set 
measures was whether or not the measure was relevant to the Medicaid 
population. While NQF endorsement signifies that measures have been 
deemed as meeting certain criteria for scientific soundness, validity 
and reliability, requiring NQF endorsement would have eliminated 
inclusion of measures in the initial core set that are relevant for 
assessing important aspects of care for the Medicaid population. 
Similarly, selecting only HEDIS measures, which were originally 
developed for health plan use, would have limited the initial core 
set's ability to address the range of care settings and conditions 
relevant to the Medicaid population.
    Comment: Public comments questioned the appropriateness of some 
proposed measures.
    Response: These comments are appreciated and helped us narrow the 
list. Each measure included in the initial core set has been compared 
against five criteria--importance, scientific evidence, scientific 
soundness, alignment with existing programs and feasibility for State 
reporting. Public comments related to specific measures were also 
reviewed and considered. To aid in assessing each measure for inclusion 
in the initial core set, specific information was collected for each 
measure, including:
     Measure description, numerator, denominator and 
exclusions.
     Data sources (for example, claims, medical records, 
electronic health records).
     Description of health importance, prevalence, financial 
importance and opportunity for improvement, including what is known 
about gaps in care and health care disparities.

[[Page 289]]

     Brief description of the scientific literature, including 
what is known about effectiveness of the intervention being addressed, 
and what is known about management and follow-up.
     Published clinical guidelines relevant to the measure.
     Validity and reliability of results, including a 
description of the study sample and methods used.
     Performance rates (most recent and two years prior).
    Comment: Two comments requested clarification on whether the 
initial core measures would be applied to Medicaid fee-for-service, 
Medicaid managed care or both types of health care delivery systems. 
Other commenters requested clarification on the target Medicaid 
population, particularly since NCQA measures included in the draft 
measures list had varying age ranges.
    Response: The initial core set will be used by States to assess the 
quality of health care provided in their Medicaid programs for adults 
(ages 18 years and older) and across all health care delivery systems 
(for example, fee-for-service, managed care, primary care case 
management). We understand that some of the measures are currently 
specified only for a particular delivery system (for example, managed 
care). 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.
    Comment: Multiple comments suggested including measures related to 
patient safety and rehabilitation services. Specifically, commenters 
noted the need for measures that address a range of disabilities 
present among Medicaid beneficiaries and those receiving home and 
community-based services. The need for outcome measures for management 
of chronic conditions and care coordination measures was also noted.
    Response: The measurement topic areas identified in these public 
comments are ones that CMS recognizes as important to assessing the 
health care quality of all adults enrolled in Medicaid, and we agree on 
the importance of measurement for chronic conditions and care 
coordination as well as for those receiving home and community-based 
services. However, the Subcommittee did not identify any existing 
measures in these areas that met the criteria for scientific soundness. 
As such, these topics will be considered measurement gap areas and will 
be prioritized for new measure development as part of the Medicaid 
Adult Quality Measures Program required under this statute.
    Comment: In addition to public comments received about each of the 
proposed measures, 43 measures were suggested by the public.
    Response: We appreciate these suggestions. Forty-two of the 43 
measures had been previously considered by the Subcommittee and CMS for 
inclusion in the draft core measures set. The one measure that had not 
been considered was a newly developed measure that had not appeared in 
the original inventory of candidate measures (Healthy Term Newborn). 
The Subcommittee reviewed all 43 of these measures again and evaluated 
them based on the established selection criteria. The Healthy Term 
Newborn measure did not rate highly when compared against the selection 
criteria and the Subcommittee felt the measure would be more effective 
if paired with a process of care measure.
    For additional information on consideration of the public comments 
and the finalization of the initial core set of health care quality 
measures for Medicaid-eligible adults, a background report can be found 
at: https://www.ahrq.gov/.

IV. Collection of Information Requirements

    This final notice announces the initial core set of health care 
quality measures for Medicaid-eligible adults for voluntary use by 
State Medicaid programs. As required in statute, by January 1, 2013, 
CMS will issue guidance for submitting the initial core set to CMS in a 
standardized format. States choosing to collect the initial core set of 
measures will use that reporting template to submit data to CMS. 
Voluntary reporting will not begin until December 2013.
    The guidance, core measures, and template are subject to the 
Paperwork Reduction Act and will be submitted to the Office of 
Management and Budget (OMB) for their review and approval at a later 
time. No persons are required to respond to a collection of information 
(whether voluntary or mandatory) unless it displays a valid OMB control 
number issued by OMB.

V. Executive Order 12866

    In accordance with the provisions of Executive Order 12866, this 
notice was reviewed by the Office of Management and Budget.

    Authority:  Sections XIX and XXI of the Social Security Act (42 
U.S.C. 13206 through 9a).

    Dated: November 16, 2011.
Marilyn B. Tavenner,
Acting Administrator, Centers for Medicare & Medicaid Services.

    Approved: December 21, 2011.
Kathleen Sebelius,
Secretary, Health and Human Services.

Initial Core Set of Health Care Quality Measures for Medicaid-Eligible 
Adults

    This table of the initial core set of health care quality measures 
for Medicaid-eligible adults includes National Quality Forum (NQF) 
identifying numbers for measures that have been endorsed, provides the 
measure stewards and indicates those measures which are used in various 
Federal and public sector programs including: Initial Core Set of 
Children's Health Care Quality Measures; the Medicare & Medicaid EHR 
Incentive Programs for eligible health care professionals and hospitals 
that adopt certified Electronic Health Record technology under the 
Final Rule published in the July 28, 2010 Federal Register (75 FR 
44314); the Medicare Physician Quality Reporting System (PQRS); Health 
Employer Data and Information Set (HEDIS); National Committee for 
Quality Assurance Accreditation; The Joint Commission's ORYX [supreg] 
Performance Measurement Initiative and other national programs.

----------------------------------------------------------------------------------------------------------------
                                                                                               Programs in which
                                                            Measure                              the measure is
                                   NQF No. [dagger]     Steward[Dagger]       Measure name         currently
                                                                                                   used[yen]
----------------------------------------------------------------------------------------------------------------
Prevention & Health Promotion..  0039...............  NCQA...............  Flu Shots for       HEDIS[supreg],
                                                                            Adults Ages 50-64   NCQA
                                                                            (Collected as       Accreditation.
                                                                            part of HEDIS
                                                                            CAHPS
                                                                            Supplemental
                                                                            Survey).
                                 N/A................  NCQA...............  Adult BMI           HEDIS[supreg],
                                                                            Assessment.         Health Homes
                                                                                                Core.
                                 0031...............  NCQA...............  Breast Cancer       MU1,
                                                                            Screening.          HEDIS[supreg],
                                                                                                NCQA
                                                                                                Accreditation,
                                                                                                PQRS GPRO,
                                                                                                Shared Savings
                                                                                                Program.

[[Page 290]]

 
                                 0032...............  NCQA...............  Cervical Cancer     MU1,
                                                                            Screening.          HEDIS[supreg],
                                                                                                NCQA
                                                                                                Accreditation.
                                 0027...............  NCQA...............  Medical Assistance  MU1,
                                                                            With Smoking and    HEDIS[supreg],
                                                                            Tobacco Use         Medicare, NCQA
                                                                            Cessation           Accreditation.
                                                                            (Collected as
                                                                            part of HEDIS
                                                                            CAHPS
                                                                            Supplemental
                                                                            Survey).
                                 0418...............  CMS................  Screening for       PQRS, CMS QIP,
                                                                            Clinical            Health Homes
                                                                            Depression and      Core, Shared
                                                                            Follow-Up Plan.     Savings Program.
                                 N/A................  NCQA...............  Plan All-Cause      HEDIS[supreg].
                                                                            Readmission.
                                 0272...............  AHRQ...............  PQI 01: Diabetes,   .................
                                                                            Short-Term
                                                                            Complications
                                                                            Admission Rate.
                                 0275...............  AHRQ...............  PQI 05: Chronic     Shared Savings
                                                                            Obstructive         Program.
                                                                            Pulmonary Disease
                                                                            (COPD) Admission
                                                                            Rate.
                                 0277...............  AHRQ...............  PQI 08: Congestive  Shared Savings
                                                                            Heart Failure       Program.
                                                                            Admission Rate.
                                 0283...............  AHRQ...............  PQI 15: Adult       .................
                                                                            Asthma Admission
                                                                            Rate.
                                 0033...............  NCQA...............  Chlamydia           MU1,
                                                                            Screening in        HEDIS[supreg],
                                                                            Women Ages 21-24    NCQA
                                                                            (same as CHIPRA     Accreditation,
                                                                            core measure,       CHIPRA Core.
                                                                            however, the
                                                                            State would
                                                                            report on the
                                                                            adult age group).
Management of Acute Conditions.  0576...............  NCQA...............  Follow-Up After     HEDIS[supreg],
                                                                            Hospitalization     NCQA
                                                                            for Mental          Accreditation,
                                                                            Illness.            CHIPRA Core,
                                                                                                Health Home
                                                                                                Core.
                                 0469...............  HCA, TJC...........  PC-01: Elective     HIP QDRP, TJC's
                                                                            Delivery.           ORYX Performance
                                                                                                Measurement
                                                                                                Program.
                                 0476...............  Prov/CWISH/NPIC/QAS/ PC-03 Antenatal     TJC's ORYX
                                                       TJC.                 Steroids.           Performance
                                                                                                Measurement
                                                                                                Program.
Management of Chronic            0403...............  NCQA...............  Annual HIV/AIDS     .................
 Conditions.                                                                Medical Visit.
                                 0018...............  NCQA...............  Controlling High    MU1,
                                                                            Blood Pressure.     HEDIS[supreg],
                                                                                                NCQA
                                                                                                Accreditation,
                                                                                                PQRS GPRO,
                                                                                                Shared Savings
                                                                                                Program.
                                 0063...............  NCQA...............  Comprehensive       MU1,
                                                                            Diabetes Care:      HEDIS[supreg],
                                                                            LDL-C Screening.    NCQA
                                                                                                Accreditation,
                                                                                                PQRS.
                                 0057...............  NCQA...............  Comprehensive       MU1,
                                                                            Diabetes Care:      HEDIS[supreg],
                                                                            Hemoglobin A1c      NCQA
                                                                            Testing.            Accreditation,
                                                                                                PQRS.
                                 0105...............  NCQA...............  Antidepressant      MU1,
                                                                            Medication          HEDIS[supreg],
                                                                            Management.         NCQA
                                                                                                Accreditation.
                                 N/A................  CMS-QMHAG..........  Adherence to        VHA.
                                                                            Antipsychotics
                                                                            for Individuals
                                                                            with
                                                                            Schizophrenia.
                                 0021...............  NCQA...............  Annual Monitoring   HEDIS[supreg],
                                                                            for Patients on     NCQA
                                                                            Persistent          Accreditation.
                                                                            Medications.
Family Experiences of Care.....  0006 & 0007........  AHRQ & NCQA........  CAHPS Health Plan   HEDIS[supreg],
                                                                            Survey v 4.0--      NCQA
                                                                            Adult               Accreditation,
                                                                            Questionnaire       Shared Savings
                                                                            with CAHPS Health   Program
                                                                            Plan Survey v       (NQF000
                                                                            4.0H--NCQA          6).
                                                                            Supplemental.
Care Coordination..............  648................  AMA-PCPI...........  Care Transition--   Health Homes
                                                                            Transition Record   Core.
                                                                            Transmitted to
                                                                            Health Care
                                                                            Professional.
Availability...................  0004...............  NCQA...............  Initiation and      MU1,
                                                                            Engagement of       HEDIS[supreg],
                                                                            Alcohol and Other   Health Homes
                                                                            Drug Dependence     Core.
                                                                            Treatment.
                                 1391...............  NCQA...............  Prenatal and        HEDIS[supreg].
                                                                            Postpartum Care:
                                                                            Postpartum Care
                                                                            Rate (second
                                                                            component to
                                                                            CHIPRA core
                                                                            measure
                                                                            ``Timeliness of
                                                                            Prenatal Care,''
                                                                            State would now
                                                                            report 2/2
                                                                            components
                                                                            instead of 1).
----------------------------------------------------------------------------------------------------------------
[dagger] NQF ID National Quality Forum identification numbers are used for measures that are NQF-endorsed;
  otherwise, NA is used.
[Dagger] Measure Steward:
AHRQ--Agency for Healthcare Research and Quality.
CMS--Centers for Medicare & Medicaid Services.
CMS-QMHAG--Centers for Medicare & Medicaid Services, Quality Measurement and Health Assessment Group.
HCA, TJC--Hospital Corporation of America-Women's and Children's Clinical Services, The Joint Commission.
NCQA--National Committee for Quality Assurance.
Prov/CWISH/NPIC/QAS/TJC--Providence St. Vincent Medical Center/Council of Women's and Infant's Specialty
  Hospitals/National Perinatal Information Center/Quality Analytic Services/The Joint Commission.
TJC--The Joint Commission.
[yen] Programs in which Measures are Currently in Use:
CHIPRA Core--Children's Health Insurance Program Reauthorization Act--Initial Core Set.
CMS QIP--CMS Quality Incentive Program.

[[Page 291]]

 
HIP QDRP--Hospital Inpatient Quality Data Reporting Program.
Health Homes Core--CMS Health Homes Core Measures.
MU1--Meaningful Use Stage 1 of the Medicare & Medicaid Electronic Health Record Incentive Programs.
PQRS--Physician Quality Reporting Program Group Practice Reporting Option.
Shared Savings Program--Medicare Shared Savings Program.
VHA--Veterans Health Administration.

[FR Doc. 2011-33756 Filed 12-30-11; 4:15 pm]
BILLING CODE P