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 Category	Initial Core Set Measureⁱ	PQMP CoE Measure Assignment
*Cross-Cutting Categories*
Duration of enrollment	n/a	Duration of enrollment/continuity of insurance coverage (standalone measure and risk-adjustment measure)ⁱⁱ
Availability of services	Children and adolescents' access to primary care practitioners, by age and total	Availability of high-risk obstetric services^vii
Availability of services		Availability of services (other than high-risk obstetric services)^viii
Family experiences of care	HEDIS CAHPS 4.0 instruments including supplements for children with chronic conditions and Medicaid plans	Inpatient family experiences of care (Pediatric H-CAHPS)^vi
Family experiences of care		Youth-reported survey (literacy, confidentiality, risk-taking behaviors)^iv
Identification of children with special health care needs	n/a	Identification of children with special health care needsⁱⁱⁱ
Continuum of care	n/a	Continuum of care^v
Transitions/Care coordination	n/a	General medication reconciliation^vii,2
		Quality of transitions from pediatric- to adult-focused care^vi
		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 readmissions	n/a	Hospital readmissions^vi
Person-reported outcomes	n/a	Person-reported outcomes, including functional assessmentⁱⁱ
Quality of care for children in the child welfare system	n/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 identified^iv
Quality to cost	n/a	Quality to cost measureⁱⁱ
*Specific Clinical Categories*
Prevention and health promotion
Prenatal	Frequency of ongoing prenatal care	Content of prenatal care^v
	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 vertex	n/a
Immunizations	Childhood immunization status (by 2nd birthday)	n/a
Immunizations	Immunizations for adolescents (by 13^th birthday)	n/a
Screening	Weight assessment for children/adolescents	BMI followup and treatment^viii
	Use of standardized screening tools for potential delays in social and emotional development	Developmental screening and followup^v,4
	Chlamydia screening for women ages 16-20	Adolescent depression screening, diagnosis, treatment, followup^iv
	Chlamydia screening for women ages 16-20	Alcohol and substance use screening, diagnosis, treatment, followup^iv
Well child care visits (WCVs)	WCVs in the first 15 months of life	Content of well-child care visits^iv
	WCVs in the 3^rd, 4^th, 5^th, and 6^th years of life	Content of well-child care visits^iv
	WCVs for 12-21 years of age—with PCP or Ob-gyn	Content of well-adolescent care visits^iv
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 dispensing	n/a
Upper Respiratory—Appropriate Use of Antibiotics	Otitis Media with Effusion—avoidance of inappropriate use of systemic antimicrobials—ages 2-12	Otitis Media with Effusion—avoidance of inappropriate use of systemic antimicrobials—ages 2-12^ii,4
Dental	Total EPSDT eligibles who received dental treatment services (EPSDT CMS Form 416, Line 12C)	Dental treatment services^v,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 measure^vi
Inpatient Patient Safety⁵		Septicemia^viii
Neonatal Intensive Care Unit (NICU)		Temperature on admission to NICU^vii
		NICU outcomesⁱⁱ
		NICU costⁱⁱ
Pediatric Intensive Care Unit (PICU)		Pediatric intensive care unit (TBI)^v
Imaging (overuse)	n/a	Imaging for seizures and headache^viii
Management of Chronic Conditions⁶
Respiratory
Asthma	Annual number of asthma patients (≥1 year old) with ≥ one asthma related emergency department visit	Asthma ED visit^vii,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 illness	Followup after mental hospitalization^vii
		Medication reconciliation—mental health^vii
		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/a	Sickle cell treatment^viii
Access to disability support services	n/a	Access to disability support services^vi

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 https://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 https://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.

Page last reviewed May 2012

Internet Citation: CHIPRA Measures by CHIPRA Categories. May 2012. Agency for Healthcare Research and Quality, Rockville, MD. https://archive.ahrq.gov/policymakers/chipra/pqmpmeasures.html