AHRQ's Activities - CHIPRA Quality Measure Identification and Improvement

On September 28, 2010, Denise Dougherty made this presentation at the 2010 Annual Conference. Select to access the PowerPoint® presentation (858 KB). Free PowerPoint® Viewer (Plugin Software Help).

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AHRQ's Activities—CHIPRA Quality Measure Identification and Improvement

Denise Dougherty, Ph.D.

Senior Advisor, Child Health and Quality Improvement

Agency for Healthcare Research and Quality

AHRQ Annual Conference
CHIPRA Session
September 28, 2010
 

Slide 2

Overview

• AHRQ's research agenda and children.
• AHRQ's activities in CHIPRA.

Slide 3

AHRQ Activities Related to Children

• Congress made children one of AHRQ's priority populations:
  • To be included in all AHRQ activities.
  • Other related populations:
    • Racial and ethnic minorities.
    • Low-income.
    • Individuals with special health care needs.
    • Rural.
• Bottom line: projects on children always welcome.

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AHRQ Priorities

Patient Safety

• Health IT
  
• Patient Safety Organizations
  
• New Patient Safety Grants

Effective Health Care Program

• Comparative Effectiveness Reviews
  
• Comparative Effectiveness Research
  
• Clear Findings for Multiple Audiences

Other Research & Dissemination Activities

• Quality & Cost-Effectiveness, e.g. Prevention and Pharmaceutical Outcomes
  
• U.S. Preventive Services Task Force
  
• MRSA/HAIs

Medical Expenditure Panel Surveys

• Visit-Level Information on Medical Expenditures
  
• Annual Quality & Disparities Reports

Ambulatory Patient Safety

• Safety & Quality Measures, Drug Management and Patient-Centered Care
  
• Patient Safety Improvement Corps

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AHRQ Resources in Quality Measurement

• Comparative effectiveness research.
• AHRQ research funding: High-impact, improve quality.
• Healthcare quality measurement:
  • Pediatric Quality Indicators
  • CAHPS
  • MEPS
  • NHQR/DR (see Fact Sheet)

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CER Projects Affecting Child Health (Funded by ARRA)

• Comparative Safety and Effectiveness of Stimulants in Medicaid Youth with ADHD, University of Florida
• Off-label Prescribing: Comparative Evidence, Regulation and Utilization, Brigham and Women's Hospital
• Pregnancy Outcomes and Asthma Medications in Pregnancy, UC-San Diego
• Measuring Pediatric Inpatient Medication Use, University of Rhode Island
• More information ARRA-funded CER projects: www.effectivehealthcare.ahrq.gov

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AHRQ's Fiscal 2011 Budget Proposal for AHRQ

• Obama Administration proposed FY 2011 budget includes $611 million for AHRQ—up from $397 million in FY 2010:
  • $286 million for patient-centered health research, up $261 million over the FY 2010 budget.
  • $32 million for health information technology research, a $4 million increase from FY 2010.
  • $65 million for patient safety research, including $34 million to reduce and prevent healthcare-associated infections

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AHRQ CHIPRA Partnerships with CMS

• Title IV—Strengthening Quality of Care and Health Outcomes
  • Measures:
    • Identification and posting of initial Core Set of children's health care quality measures—Done!
    • Pediatric Quality Measures Program—Under Way
  • Beyond Measures:
    • CMS State Quality Demonstration Projects—National Evaluation
    • Model Children's Electronic Health Record Format
    • CAHPS Benchmarking Database as source of State reports on CAHPS Data (Section 402)

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Initial Core Measures

Slide 10

Initial Core Measures

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Initial Core Set of Pediatric Quality Measures

• 24 recommended quality measures for voluntary use by CHIP, Medicaid programs:
  • Prevention/Health Promotion (13): Prenatal/Perinatal, Screening, Immunizations, Well-Child Care Visits, Dental
  • Management of Acute Conditions (5): Upper Respiratory, Appropriate Use of Antibiotics, Dental, Emergency Department
  • Management of Chronic Conditions (4): ADHD, Mental Health, Diabetes
  • Family Experiences of Care (1): HEDIS CAHPS 4.0 survey instruments
  • Availability (1): Access to primary care physicians

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Aligning Pediatric Quality Measures and Meaningful Use

• Four of the initial quality measures under CHIPRA align with proposed HITECH meaningful use quality measures:
  • BMI for children ages 2-18 years (NCQA).
  • Follow-up care for children prescribed medication for ADHA (NCQA).
  • Annual Hemoglobin A1C testing for children (NCQA).
  • Pharyngitis and appropriate antibiotic dispensing (NCQA).

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Continued Work on CHIPRA: AHRQ's Role

• New Funding Opportunity: CHIPRA Pediatric Healthcare Quality Measures Program Centers of Excellence (U18):
  • Posted April 22, 2010
  • Review of applications: October 18, 2010
  • Work begins by end of 2010
  • Will build on expert Meeting on Measurement Criteria February 24-25, 2010

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Next: Pediatric Quality Measures Program—Aims

• To enhance and improve the initial core set.
• To develop additional measures and measure criteria so that CHIPRA core measures:
  • Are evidence-based.
  • Cut across a wide range of child and perinatal conditions and care settings.
  • Can be vertically and horizontally integrated.
  • Enable assessment of disparities in care.
• To incorporate multi-stakeholder engagement, including the public.
• To post improved core measure sets, every year beginning January 2013.
• To leverage health IT and collect data in a standard format.

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For more information

• Denise.dougherty@ahrq.hhs.gov
• Edwin.Lomotan@ahrq.hhs.gov
• Maushami.DeSoto@ahrq.hhs.gov