Examples of How States Use Quality Measures

Child Health Care Quality Toolbox

The Child Health Toolbox contains concepts, tips, and tools for evaluating the quality of health care for children.

 

 


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Here are a few examples of how States use their performance measures and display them on their Web sites. We have included examples of Web-based reports that show Health Plan Employer Data and Information Set (HEDIS®) measures, Consumer Assessment of Health Plans (CAHPS®) survey results, and Child and Adolescent Health Measurement Initiative (CAHMI) measures. The names and current locations of their latest reports, as well as the home page of the agency sponsoring the report, are listed. If the location of the report on the agency's Web site is changed or should newer reports become available, you should be able to find them on the agency's home page.

 

Online Resource: In addition to the States and reports listed below, be sure to peruse the CAHPS® Child Survey Sponsor Profiles. There you will find examples of how seven States, (Colorado, Kansas, Michigan, New Mexico, Pennsylvania, Utah, and Washington) used the CAHPS® Child Survey. It also gives contact information for finding out more about those projects. Go to: http://www.ahrq.gov/chtoolbx/cahpspro.htm

 

Arizona

Annual KidsCare Report to the Governor

The Arizona Health Care Cost Containment System provides an annual report to the Governor and members of the public on the performance of the KidsCare program, Arizona's State Children's Health Insurance Program (SCHIP). Three of the measures included in the report are based on HEDIS®: immunizations, well child care visits, and access to primary care practitioners.

Online Resources:

The report is available online. Go to: http://www.ahcccs.state.az.us/Publications/Reports/KidsCareAnnualRpts/2003/kcannrpt_01_03.asp.

For the home page of the agency, go to: http://www.ahcccs.state.az.us.

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Michigan

2001 Medicaid Consumer Satisfaction Survey

The Medical Services Administration (MSA) of the Michigan Department of Community Health administers the State's Medicaid program. The MSA uses the CAHPS® survey instrument to conduct annual consumer satisfaction surveys of beneficiaries enrolled in health plans under Medicaid.

Online Resources:

For the Michigan Department of Community Health's home page, go to: http://www.michigan.gov/mdch.

The consumer-oriented brochure, "Guide to Michigan Medicaid Plans," is another Michigan Department of Community Health quality initiative. To download the report in PDF format PDF file (179 KB), go to: http://www.michigan.gov/documents/QualityCheckup02_11547_7.pdf.

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Minnesota

HEDIS® 2003 Medicaid Managed Care Results

The Minnesota Department of Human Services has produced a report, HEDIS® 2003 Medicaid Managed Care Results, showing multiple HMO rates for six child HEDIS® indicators for Medicaid and commercial populations. The previous year's report, Primer on the Medicaid and MinnesotaCare HEDIS® 2002, is also worth a review. It shows similar data in a more detailed format with explanations of how to use HEDIS® data.

Online Resources:

http://www.health.state.mn.us/divs/hpsc/mcs/hedis02.htm

For the department's home page, go to: http://www.dhs.state.mn.us.

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New York

Managed Care Plan Performance—Quality, Access to Care, and Consumer Satisfaction

The Bureau of Quality Management and Outcomes Research, Office of Managed Care, New York State Department of Health uses performance measures to assess and improve the quality of care and increase the accountability of all managed care plans licensed to operate in New York State. The measures, known as Quality Assurance Reporting Requirements, are largely adopted from HEDIS®.

The report includes information on plans serving commercial, Medicaid, and the State's SCHIP (Child Health Plus) enrollees. Plan results are compared to national averages and goals where possible.

Online Resources:

For more information and a link to the report, go to:
http://www.health.state.ny.us/health_care/managed_care/qarrfull/qarr_2007/index.htm.

For the home page of the New York managed care office, go to: http://www.health.state.ny.us/nysdoh/mancare/mcmain.htm.

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North Carolina

Comparisons of HEDIS® Results by Systems of Care

The North Carolina Division of Medical Assistance Managed Care Quality Management Section produces one of the few reports that includes children with special needs. This report shows the results of 16 HEDIS® benchmarks for four programs including primary care case management.

Online Resources:

http://qa.dhhs.state.nc.us/dma/quality/hedis2002.pdf.

For the quality management home page, go to: http://www.dhhs.state.nc.us/dma/ca/qm.htm

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Ohio

Medicaid Managed Care Customer Satisfaction Survey

Ohio's Health Plans, a division of the Ohio Department of Job and Family Services, administers Medicaid and SCHIP, among other programs. The Department uses the CAHPS® survey instrument to gather data and develop a report assessing consumer satisfaction under Medicaid managed care and fee-for-service programs.

Online Resources:

For the most recent report, go to: http://jfs.ohio.gov/ohp/satisfaction/mmcp2002b/index.stm.

For the agency's home site, go to: http://jfs.ohio.gov/ohp/index.stm.

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Rhode Island

Analysis of RIteCare Utilization Data: Asthma Surveillance 1998-2002

Rhode Island 's RIteCare program includes Medicaid and SCHIP. It is administered by the Rhode Island Department of Human Services, which conducts special studies on issues of relevance to the enrolled population. A report monitoring trends in the diagnosis and treatment of asthma from 1998 to 2002 was prepared in 2003.

Online Resources:

Download the report in PDF format PDF file (185 KB). Go to: http://www.dhs.ri.gov/dhs/reports/ristats%20vol%202%20issue%203.pdf.

For other Rlte reports, go to: http://www.dhs.ri.gov/dhs/dreports.htm

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Vermont

Health Care Quality Report

The Vermont Program for Quality in Health Care (VPQHC), a private, nonprofit corporation formed in 1998, produces an annual report that measures health care quality and utilization across Vermont based on a set of commonly used indicators, including HEDIS® measures. In addition, the report highlights specific efforts VPQHC and others have undertaken to improve health care quality for Vermonters.

Online Resource: To access the most current Quality Report, go to: http://www.vpqhc.org/interior.php/pid/17/sid/204

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Washington State

2002 CAHPS® Results

Since 1997, Washington State's Department of Social and Health Services Medical Assistance Administration has been conducting CAHPS® for Medicaid clients. Assessments are based on the health care services and experiences of:

  • Healthy Options general child population.
  • Healthy Options children with chronic care conditions population.
  • Kaiser Foundation Health Plan child population.
  • Children in SCHIP.

Results of the survey are published in a report entitled 2002 Washington Consumer Assessment of Health Plans (CAHPS®) Survey: Washington State Medicaid Client Satisfaction Results.

2003 HEDIS® Report

The Quality Assessment, Improvement, and Monitoring office of the Division of Medical Management, Medical Assistance Administration of the Washington State Department of Social and Health Services produced a report showing Medicaid and commercial rates for seven HEDIS® benchmarks.

Promoting Healthy Development Survey

In 2000, Washington State served as a pilot site for two Child and Adolescent Health Measurement Initiative (CAHMI) products. A pilot the of Promoting Healthy Development Survey (PHDS) included Washington State Healthy Options children served by nine managed care organizations, as well as children receiving care through Washington fee-for-service and primary care case management programs.

CAHMI Results

Online Resources:

Download the CAHPS® reports in PDF format. Go to: http://fortress.wa.gov/dshs/maa/cahps/.

For the home page of Washington's Medical Assistance Administration, go to: http://fortress.wa.gov/dshs/maa/.

For the CAHMI home page, go to: http://www.cahmi.org.

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Wisconsin

MEDDIC-MS and MEDDIC-MS

Automated clinical performance measures called MEDDIC-MS and MEDDIC-MS SSI have been in use in Wisconsin since 2002. These measures are specifically designed for very large healthcare delivery systems for Medicaid, SCHIP, and Supplemental Security Income (SSI) populations.

Wisconsin publicly reports 58 measure numerators for 14 health maintenance organizations (HMOs) in Family Medicaid and SCHIP programs and 34 measure numerators for the SSI program; Wisconsin is the only State publicly reporting SSI managed care quality data. Data on additional numerators for specific age cohorts are also collected. Public reporting has encouraged HMOs to focus on performance improvement and sustained improvement has occurred in a number of key indicators.

Online Resource:

For more information on MEDDIC-MS and MEDDIC-MS SSI performance measures and the latest clinical performance data for Wisconsin, go to:
http://www.dhs.wisconsin.gov/emsc/mission.htm.

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Current as of September 2012
Internet Citation: Examples of How States Use Quality Measures: Child Health Care Quality Toolbox. September 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/chtoolbx/measures/measure8.html