CHIPRA Measures by CHIPRA Categories

A list of priority topics being addressed by Centers of Excellence.

Initial Core Set and Pediatric Quality Measures Program Centers of Excellence Measure Assignments

The Agency for Healthcare Research and Quality (AHRQ) has made seven awards to Centers of Excellence (CoE) across the United States. Each CoE has a broad coalition of consumer stakeholders, health services researchers, and State agency partners to inform its work. Each CoE will develop or enhance five to six pediatric quality measures and test the performance of those measures against specific criteria identified in the CHIPRA legislation.

A list of the priority topics being addressed by the Centers of Excellence is below.

CHIPRA CategoryInitial Core Set MeasureiPQMP CoE Measure Assignment
Cross-Cutting Categories
Duration of enrollmentn/aDuration of enrollment/continuity of insurance coverage (standalone measure and risk-adjustment measure)ii
Availability of servicesChildren and adolescents' access to primary care practitioners, by age and totalAvailability of high-risk obstetric servicesvii
Availability of services (other than high-risk obstetric services)viii
Family experiences of careHEDIS CAHPS 4.0 instruments including supplements for children with chronic conditions and Medicaid plansInpatient family experiences of care (Pediatric H-CAHPS)vi
Youth-reported survey (literacy, confidentiality, risk-taking behaviors)iv
Identification of children with special health care needsn/aIdentification of children with special health care needsiii
Continuum of caren/aContinuum of carev
Transitions/Care coordinationn/aGeneral medication reconciliationvii,2
Quality of transitions from pediatric- to adult-focused carevi
Transitions between care settingsiii
Identification of social complexity for care coordinationiii
Care coordination for children with special health care needs in the context of the medical homeiii
Hospital readmissionsn/aHospital readmissionsvi
Person-reported outcomesn/aPerson-reported outcomes, including functional assessmentii
Quality of care for children in the child welfare systemn/a (specifically to this population, although other measures can be used with this population)Quality of care for children in the child welfare system, including psychotropic/antipsychotic use and care coordination for socially complex children3; others to be identifiediv
Quality to costn/aQuality to cost measureii
Specific Clinical Categories
   Prevention and health promotion
  • Prenatal
Frequency of ongoing prenatal careContent of prenatal carev
Timeliness of prenatal care—the percentage of deliveries that received a prenatal care visit as a member of the organization in the first trimester or within 42 days of enrollment in the organization
Percent of live births weighing less than 2,500 grams
  • Perinatal
Cesarean rate for nulliparous singleton vertexn/a
  • Immunizations
Childhood immunization status (by 2nd birthday)n/a
Immunizations for adolescents (by 13th birthday)
  • Screening
Weight assessment for children/adolescentsBMI followup and treatmentviii
Use of standardized screening tools for potential delays in social and emotional developmentDevelopmental screening and followupv,4
Chlamydia screening for women ages 16-20Adolescent depression screening, diagnosis, treatment, followupiv
Alcohol and substance use screening, diagnosis, treatment, followupiv
  • Well child care visits (WCVs)
WCVs in the first 15 months of lifeContent of well-child care visitsiv
WCVs in the 3rd, 4th, 5th, and 6th years of life
WCVs for 12-21 years of age—with PCP or Ob-gynContent of well-adolescent care visitsiv
  • Dental
Total eligibles receiving preventive dental services (EPSDT measure Line 12B)n/a
   Management of acute conditions
  • Upper Respiratory—Appropriate Use of Antibiotics
Pharyngitis—appropriate testing related to antibiotic dispensingn/a
Otitis Media with Effusion—avoidance of inappropriate use of systemic antimicrobials—ages 2-12Otitis Media with Effusion—avoidance of inappropriate use of systemic antimicrobials—ages 2-12ii,4
  • Dental
Total EPSDT eligibles who received dental treatment services (EPSDT CMS Form 416, Line 12C)Dental treatment servicesv,4
  • Emergency Department
Emergency Department Utilization—Average number of ED visits per member per reporting period.n/a; except see above re asthma ED measure
  • Inpatient Patient Safety5
Pediatric catheter-associated blood stream infection (CLABSI)� rates (PICU and NICU)Global patient safety tool measurevi
Septicemiaviii
  • Neonatal Intensive Care Unit (NICU)
Temperature on admission to NICUvii
NICU outcomesii
NICU costii
  • Pediatric Intensive Care Unit (PICU)
Pediatric intensive care unit (TBI)v
  • Imaging (overuse)
n/aImaging for seizures and headacheviii
   Management of Chronic Conditions6
  • Respiratory
  
  • Asthma
Annual number of asthma patients (≥1 year old) with ≥ one asthma related emergency department visitAsthma ED visitvii,4
  • Respiratory bundle
Respiratory bundle (asthma and bronchitis)viii
  • Attention Deficit Hyperactivity Disorder
Followup care for children prescribed ADHD medication (continuation and maintenance phase)Followup care for children with ADHD (diagnosis, treatment, management)v
  • Mental health7
Followup after hospitalization for mental illnessFollowup after mental hospitalizationvii
Medication reconciliation—mental healthvii
Mental health hospital admissionsiii
Mental health hospital qualityiii
Mental health ED admissionsiii
Mental health ED qualityiii
  • Diabetes
Annual hemoglobin A1C testing (all children and adolescents diagnosed with diabetes) 
  • Sickle cell
n/aSickle cell treatmentviii
  • Access to disability support services
n/aAccess to disability support servicesvi

Legend:

CAHPS® = Consumer Assessment of Health Providers and Systems.
CHIPRA = Children's Health Insurance Reauthorization Act.
COE = Center(s) of Excellence (PQMP.)
HEDIS = Health Employer Data Information System (NCQA).
n/a = Not applicable.
NCQA = National Committee for Quality Assurance.
PQMP = Pediatric Quality Measures Program (CHIPRA).

Prepared by: Agency for Healthcare Research and Quality CHIPRA PQMP Team—contact denise.dougherty@ahrq.hhs.gov; maushami.desoto@ahrq.hhs.gov.

1. For information on the COEs (Centers of Excellence), visit http://www.ahrq.gov/chipra/pqmpfact.htm.
2. Also see mental health.
3. Also see Care coordination for socially complex children. NCINQ will build on the measure being developed by COE4CCN to make it applicable for children in the child welfare system.
4. In cases where a measure topic assigned to the PQMP COEs is similar to an initial core measure, the measure assignment is to improve on the initial core measure.
5. Can also apply to chronic conditions.
6. Also see under screening mention of diagnosis, treatment and followup.
7. Also see screening under prevention and health promotion.


i. For details, see http://www.ahrq.gov/chipra/corebackground/corebacktab.htm; Initial Core Set of Children’s Health Care Quality Measures:
Technical Specifications and Resource Manual for Federal Fiscal Year 2011 Reporting
. For reports on States' voluntary reporting of the initial core set, visit http://medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/CHIPRA-Initial-Core-Set-of-Childrens-Health-Care-Quality-Measures.html.
ii. Silber/CHOP.
iii. Mangione-Smith/COE4CCN.
iv. Scholle/NCINQ.
v. Sachdeva/PMCoE.
vi. Schuster/CEPQM.
vii. Kleinman/CAPQM.
viii. Freed/Q-METRIC.

Current as of May 2012
Internet Citation: CHIPRA Measures by CHIPRA Categories. May 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/policymakers/chipra/pqmpmeasures.html