Environmental Scan of Measures for Medicaid Title XIX Home and Community-Based Services
Table of Contents
10. Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Performance measurement: accelerating improvement. Pathways to Quality Health Care Series. Board on Health Care Services, Institute of Medicine. Washington, DC: National Academies Press; 2006.
11. Teaster PB, Otto JM, Dugar TA, et al. Abuse of adults age 60+: The 2004 survey of State adult protective services. (Prepared for the National Center on Elder Abuse under Grant No. 90-AM-2792 from the Administration on Aging, U.S. Department of Health and Human Services.) Springfield, IL: National Adult Protective Services Association; 2006. Available at: http://www.apsnetwork.org/Resources/docs/AbuseAdults60.pdf.
12. Rosenthal J, Takach M. 2007 Guide to State adverse event reporting systems. Publication No. 2007-301. State Health Policy Survey Report 2007 Dec;1(1). Portland, ME: National Academy for State Health Policy.
13. Hussey PS, Mattke S, Morse L, et al. Evaluation of the use of AHRQ and other quality indicators: final contract report. (Prepared by RAND under Contract No. WR-426-HS). AHRQ Publication No. 08-M012-EF. Rockville, MD, Agency for Healthcare Research and Quality; December 2007.
19. Long-Term care: Federal oversight of growing Medicaid home and community-based waivers should be strengthened. Publication No. GAO-03-576. Washington, DC: General Accounting Office; June 20, 2003. http://www.gao.gov/new.items/d03576.pdf.
20. Corrigan JM, Eden J, Smith B. Leadership by example: coordinating government roles in improving health care quality. Committee on Enhancing Federal Healthcare Quality Programs, Institute of Medicine. Washington, DC: The National Academies Press; 2003.
22. Scheuren F. What is a survey? 2nd ed. Alexandria, VA: American Statistical Association, Survey Research Methods Section; 2004. Available at: http://www.whatisasurvey.info/.
i. The legislative language implies a one-time, rather than longitudinal, assessment of HCBS services and the system used to deliver them under Medicaid. Furthermore, AHRQ has no regulatory authority over the Medicaid program, which falls under the jurisdiction of the Centers for Medicare & Medicaid Services (CMS). Only CMS can mandate the use of specific measures by State Medicaid programs on an ongoing basis.
ii. Section 6086(b), PL 109-171, included in Appendix VI.
iii. The full methodology for the measure scan is described in Medicaid Home and Community-Based Services Measure Scan: Project Methodology, available at .
iv. 72 Fed Reg 106, 30800-3, June 4, 2007.
v. Refer to, for example, "Selecting Measures for the National Health Care Quality Data Set" and the summaries included in Appendix E of the Institute of Medicine's Envisioning the National Health Care Quality Report (2001).
vi. During its first meeting, the TEP recommended that assessment of level of care and financial integrity of Medicaid payments be taken off the table as dimensions of program performance.
vii. AHRQ'S proprietary measure request was articulated in the formal Call for Measures referenced above (Federal Register, June 4, 2007).
viii. CFR §441.302. These include: consistent determination of level of care for program eligibility; individualized service planning; use of qualified providers; maintenance of participant health and welfare; administrative oversight by the State Medicaid Agency; and integrity of financial payments.
ix. Use of the term "stewardship," in place of promotion, was suggested during the review process, to more broadly describe this function.
x. Historically, persons with intellectual disabilities have been excluded from pain research.
xi. As used in this report, the term "serious reportable adverse health event" is defined as an event that leads to an undesirable outcome (death or serious harm) or significant potential for such an outcome, and the event was not at all expected or acceptable. The term is used broadly to encompass the terms "critical incidents," "sentinel events," and "adverse events."
xv. In response to two congressional mandates included in the Medicare Prescription Drug Improvement and Modernization Act of 2003, the IOM initiated the project Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. From this project came the report, Performance Measurement: Accelerating Improvement, which called for the development of a national system of performance measurement and reporting based on shared accountability, a system that holds all providers who participate in a person's care responsible for the outcomes of that care.12
xvi. A description of the Prevention Quality Indicators can be found at http://www.qualityindicators.ahrq.gov/Modules/pqi_overview.aspx.
xvii. Several TEP members thought this concept applied more broadly to populations outside of individuals with serious mental illness.
xix. The Quality Framework can be found online at http://www.cms.hhs.gov/HCBS/downloads/qualityframework.pdf.
xx. Published in 72 Fed Reg 232, 68077-93, December 4, 2007.
xxi. More information is available at http://www.cms.hhs.gov/NursingHomeQualityInits/20_NHQIMDS20.asp.
xxiii. More information is available at http://psnet.ahrq.gov/resource.aspx?resourceID=5363.
xxiv. Description available at http://www.pressganey.com/cs/research_and_analysis/patient_satisfaction/....
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