Appendix 5. Measures Recommended for the Core Set and Posted for Public Comment

Identifying Health Care Quality Measures for Medicaid-Eligible Adults

#NQF IDaMeasure OwnerMeasure NameEHRb

Prevention & Health Promotion

1

0039

NCQA

Flu Shots for Adults Ages 50-64 (Collected as part of HEDIS CAHPS Supplemental Survey)

 

2

0421

CMS

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up

X

3

0031

NCQA

Breast Cancer Screening

X

4

0032

NCQA

Cervical Cancer Screening

X

5

NA

RAND

Alcohol Misuse: Screening, Brief Intervention, Referral for Treatment

 

6

0027

NCQA

Medical Assistance With Smoking and Tobacco Use Cessation

X

7

0418

CMS

Screening for Clinical Depression and Follow-Up Plan

 

8

NA

NCQA

Plan All-Cause Readmission

 

9

0272

AHRQ

PQI 01: Diabetes, Short-term Complications

 

10

0273

AHRQ

PQI 02: Perforated Appendicitis

 

11

0274

AHRQ

PQI 03: Diabetes, Long-term Complications

 

12

0275

AHRQ

PQI 05: Chronic Obstructive Pulmonary Disease

 

13

0276

AHRQ

PQI 07: Hypertension

 

14

0277

AHRQ

PQI 08: Congestive Heart Failure

 

15

0280

AHRQ

PQI 10: Dehydration

 

16

0279

AHRQ

PQI 11: Bacterial Pneumonia

 

17

0281

AHRQ

PQI 12: Urinary Tract Infection Admission Rate

 

18

0282

AHRQ

PQI 13: Angina Without Procedure

 

19

0638

AHRQ

PQI 14: Uncontrolled Diabetes Admission Rate

 

20

0283

AHRQ

PQI 15: Adult Asthma

 

21

0285

AHRQ

PQI 16: Lower Extremity Amputations Among Patients With Diabetes

 

Management of Acute Conditions

22

0052

NCQA

Use of Imaging Studies for Low Back Pain

X

23

0640

TJC

HBIPS-2 Hours of Physical Restraint Use

 

24

0576

NCQA

Follow-Up After Hospitalization for Mental Illness

 

25

0476

Providence St. Vincent Medical Center

Appropriate Use of Antenatal Steroids

 

26

0469

Hospital Corporation of America

Elective Delivery Prior to 39 Completed Weeks Gestation

 

27

0648

AMA-PCPI

Timely Transmission of Transition Record (Inpatient Discharges to Home/Self Care or Any Other Site of Care)

 

28

0647

AMA-PCPI

Transition Record With Specified Elements Received by Discharged Patients (Inpatient Discharges to Home/Self Care or Any Other Site of Care)

 

Management of Chronic Conditions

29

0071

NCQA

Persistence of Beta-Blocker Treatment After a Heart Attack

 

30

0018

NCQA

Controlling High Blood Pressure

X

31

0074

AMA-PCPI

Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL Cholesterol

X

32

0075

NCQA

Comprehensive Ischemic Vascular Disease Care: Complete Lipid Profile and LDL-C Control Rates

X

33

0063

NCQA

Diabetes: Lipid Profile

 

34

0057

NCQA

Comprehensive Diabetes Care: Hemoglobin A1c Testing

 

35

0036

NCQA

Use of Appropriate Medications for People With Asthma

X

36

0403

NCQA

HIV/AIDS: Medical Visit

 

37

0105

NCQA

Antidepressant Medication Management

X

38

NA

RAND

Bipolar I Disorder 2: Annual Assessment of Weight or BMI, Glycemic Control, and Lipids

 

39

NA

RAND

Bipolar I Disorder C: Proportion of Patients With Bipolar I Disorder Treated With Mood Stabilizer Medications During the Course of Bipolar I Disorder Treatment.

 

40

NA

RAND

Schizophrenia 2: Annual Assessment of Weight/BMI, Glycemic Control, Lipids

 

41

NA

RAND

Schizophrenia B: Proportion of Schizophrenia Patients With Long-term Utilization of Antipsychotic Medications.

 

42

NA

RAND

Schizophrenia C: Proportion of Selected Schizophrenia Patients With Antipsychotic Polypharmacy Utilization.

 

43

0021

NCQA

Annual Monitoring for Patients on Persistent Medications

 

44

0541

PQA

Proportion of Days Covered (PDC): 5 Rates by Therapeutic Category

 

Family Experiences of Care

45

0006

AHRQ

CAHPS Health Plan Survey v. 4.0—Adult Questionnaire

 

46

0007

NCQA

CAHPS Health Plan Survey v. 4.0H—NCQA Supplemental Items for CAHPS 4.0 Adult Questionnaire

 

Availability

47

NA

NCQA

Ambulatory Care: Outpatient and Emergency Department Visits

 

48

NA

NCQA

Inpatient Utilization: General Hospital/Acute Care

 

49

0004

NCQA

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

X

50

NA

NCQA

Mental Health Utilization

 

51

1517

NCQA

Prenatal and Postpartum Care: Postpartum Care Rate

 

a. NQF ID: National Quality Forum identification numbers are used for measures that are NQF-endorsed; otherwise, NA is used.
b. MU = Measures with an "X" are designated Meaningful Use according by legislation; in addition, for these particular measures, electronic medical record specifications have been published and are available on the Centers for Medicare & Medicaid Services Web site.

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Current as of December 2010
Internet Citation: Appendix 5. Measures Recommended for the Core Set and Posted for Public Comment: Identifying Health Care Quality Measures for Medicaid-Eligible Adults. December 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/nac/reports/nacqm11/appendix5.html