Background Report on 2013 Retirement of Measures from the Child Core Set
Appendix E presents summary results from the two scoring rounds, ordered by the number of SNAC members voting for the measure’s retirement in the final round (fewest votes to most votes). In summary, the 2013 SNAC identified three measures for retirement: Child and Adolescent Access to Primary Care Practitioners, Appropriate Testing for Children with Pharyngitis, and Annual Pediatric Hemoglobin (HbA1c) Testing. A summary of the comments for each measure, including measure-specific discussion, is provided in Appendix F.
Although the number of SNAC members who scored and voted changed between the two rounds, with 22 scoring and voting in Round 2, the median total score did not change substantially for any of the measures and was identical for seven of the measures in both rounds. The themes raised in the comments during the preliminary and final scoring rounds were similar.
Overall, SNAC members recommended retaining measures that reflected provision of preventive services for children in Medicaid/CHIP (immunizations, well-child visits) and a key outcome for births covered by Medicaid/CHIP (low birthweight). Other retained measures covered topics such as preventive care for women and adolescent girls, prenatal care, pediatric use of the emergency department, patient safety, and followup care for behavioral health and mental illness. Most SNAC members voted to retain measures they felt were significant to the Medicaid/CHIP population but recommended that they be replaced with better measures when possible. Examples of such measures include two measures of prenatal care (i.e., Timeliness of Prenatal Care and Frequency of Ongoing Prenatal Care), the body mass index (BMI) assessment for children/adolescents, and measures for which there were validity concerns (e.g., inadequate risk adjustment). As an example, a better BMI measure would indicate the actual BMI and an assessment of followup. A measure of BMI followup is in development by one of the CHIPRA Pediatric Quality Measures Program (PQMP) Centers of Excellence.8