Candidate Measure Submission Form (CPCF)
Section I. Basic Measure Information
Section II. Detailed Measure Specifications
Section III. Importance of the Measure
Section IV. Measure Categories
Section V. Evidence or Other Justification for the Focus of the Measure
Section VI. Scientific Soundness of the Measure
Section VII. Identification of Disparities
Section VIII. Feasibility
Section IX. Levels of Aggregation
Section X. Understandability
Section XI. Health Information Technology
Section XII. Limitations of the Measure
Section XIII. Summary Statement
Section XIV. Identifying Information for the Measure Submitter
Section XV. Glossary of Terms
Section XVI. Sources
In 2009, the Children's Health Insurance Program Reauthorization Act (CHIPRA) reauthorized the Children's Health Insurance Program (CHIP) originally established in 1997.1 Title IV of the law included a number of provisions aimed at improving health care quality and outcomes for children. Section 401(a) of CHIPRA called for the identification of an initial core set of health quality measures for children enrolled in Medicaid or CHIP based on measures available in 2009. The initial core set2 was recommended by the Agency for Healthcare Research and Quality (AHRQ) National Advisory Subcommittee on Children's Health Quality Measures for Medicaid and CHIP (SNAC), posted for public comment by the Secretary of the U.S. Department of Health and Human Services (HHS) on December 29, 2009, and made available for voluntary use by State Medicaid and CHIP programs in February 2011, along with technical specifications.3
Section 401 (b) of CHIPRA created the Pediatric Quality Measures Program (PQMP) to improve the initial core set of pediatric quality measures and increase the portfolio of evidence-based measures available to public and private purchasers of children's health care services, providers, and consumers. Improved core measures are to be posted annually beginning January 1, 2013. The PQMP is a partnership between AHRQ and the Centers for Medicare & Medicaid Services (CMS). As part of the PQMP, there are seven Centers of Excellence (COEs)—a consortium of academic institutions, State partners, consumers, and others—that will develop and test measures over the course of the program for categories specified by CHIPRA and topics identified by CMS and AHRQ.4 In addition to the measures submitted by the COEs, public nominations for quality measures will be solicited in the spring of each year. All submitted measures will be reviewed by a SNAC5 of the AHRQ National Advisory Council on Research and Quality (NAC). The SNAC will make recommendations to the NAC, which advises the director of AHRQ, who in turn will make recommendations to CMS and the Secretary of HHS.
CHIPRA notes that measures in the improved core sets should be evidence based; cover a full range of services, conditions, and ages; be able to identify disparities by race, ethnicity, socioeconomic status, and special health care need; be risk adjusted as appropriate; and designed to ensure that data are collected and reported in a standard format that permits comparison of quality and data at a State, plan, and provider level.
This template, the CHIPRA Pediatric Quality Measures Program (PQMP) Candidate Measure Submission Form (CPCF) was developed by the COEs, the SNAC, the CHIPRA Coordinating and Technical Assistance Center (CCTAC) at RTI International, and AHRQ as a standardized form to be used for all nominations for pediatric quality measures under the CHIPRA legislation. The first part of the CPCF template provides guidance on the submission process. The template then includes opportunities for all measure submitters to provide a basic description of their measure, and address a number of desirable measure attributes for pediatric quality measures. The desirable measure attributes include importance, evidence or other rationale for focus of the measure, scientific soundness of the measure itself, identification of disparities, feasibility, levels of aggregation, understandability, and health information technology. The form also requests identification of the limitations of the measure being submitted. It then provides an opportunity to summarize why the measure should be recommended by the SNAC, taking into account the measure's advantages and limitations in relation to the desirable measure attributes. The template requires measure submitter information, public disclosure requirement requiring signed written statement, and an opportunity to upload supplementary material including graphics, figures, tables, and any other information to facilitate review of the measure by the SNAC. Attachments may be in PDF format only. The final section of the template provides a glossary of terms. Many of the desirable attributes are similar to those called by other leading entities that solicit measures, but several are CHIPRA specific (e.g., more child focused, spotlight on disparities, and attention to specific levels of aggregation). The SNAC will interpret the extent to which the measure is suitable for voluntary use by Medicaid, CHIP, or other public and private programs, purchasers, plans, providers and consumers using the information provided in the template.
1. Children's Health Insurance Program Reauthorization Act of 2009. Public Law No. 111-3, 123 Stat. 8 (2009). Available at: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_public_laws&docid=f:publ003.111.
2. CHIPRA Initial Core Set of Children's Health Care Quality Measures. Available at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/
3. CHIPRA Initial Core Set of Children's Health Care Quality Measures: Technical Specifications and Resource Manual for Federal Fiscal Year 2011 Reporting. Available at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/Downloads/InitialCoreSetResourceManual.pdf.
4. Pediatric Quality Measures Program Centers of Excellence Grant Awards. AHRQ Publication No. 12-P006, March 2012. AHRQ, Rockville, MD. http://www.ahrq.gov/policymakers/chipra/pubs/pqmpfact.html.
5. AHRQ National Advisory Council on Research and Quality. Subcommittee on Quality Measures for Children's Health Care. Members List. 2012. Available at: http://www.ahrq.gov/policymakers/chipra/coreset/qmsnaclist12.html.