National Advisory Council Subcommittee: Identifying Quality Measures for Medicaid-eligible Adults
The proposed initial core quality measures for adults in Medicaid were identified using a transparent and evidence-based process. The Subcommittee of AHRQ's National Advisory Council considered measures drawn from a pool of nearly 1,000 measures. The Subcommittee's recommendations take into account the legislative requirement that measures be currently in use, the needs of key Medicaid adult populations, attention to important domains of quality identified by the Institute of Medicine (IOM) , and the feasibility for Medicaid programs to collect and report the measures.
Medicaid adult populations are a diverse population of low-income adults, some of whom are people with disabilities under age 65 (including individuals with intellectual or physical disability as well as serious and persistent mental illness) and others who are age 65 and older. The Subcommittee noted gaps in the availability of tested and feasible measures to capture important dimensions of care for all critical needs of Medicaid-eligible adults. The Subcommittee noted overall needs for composite measures, stratification/use of particular measures for broader age groups or other health status, and use of data from all payer measurement initiatives.
The core set represents a set of measures that are currently readily available and feasible for collection. Additionally, resources authorized by the Affordable Care Act will be devoted to measure development around concepts that will provide more useful and meaningful information about quality of care for benchmarking and improving quality for these multiple, vulnerable populations. CMS will make improvements and enhancements to the core set based on public comments on the initial preliminary recommended core measure set. In addition, AHRQ and CMS are working to identify ways to align State reporting requirements with other HHS quality reporting initiatives and requirements and to coordinate quality measurement efforts with payment reform strategies, health information technology, and electronic health record initiatives.