Medicaid Measures Open for Comment
HHS Publishes Initial Measures for Quality Program Starting January 2012
By Allison Viola, MBA, RHIA
IN MARCH 2010 President Obama signed into law the Patient Protection and Affordable Care Act (ACA), which includes many provisions calling for the implementation of quality measure- ment programs. One program that must be established by Janu- ary 2012 is the Medicaid Quality Measurement Program, which will develop, test, and validate emerging innovative evidence- based measures for Medicaid-eligible adults. ACA mandated a series of steps for the program that must be completed by 2014: x January 1, 2011: Publish an initial set of core measures and request feedback from the public in preparation for the Medicaid Quality Measurement Program
x January 1, 2012: Establish a Medicaid Quality Measurement
Program
x January 1, 2013: Develop a standardized reporting format
on the core set and procedures to encourage voluntary re-
porting by the states
x January 1, 2014: Annually publish recommended changes
to the initial core set that shall reflect the results of the test-
ing, validation, and consensus process for the development
of adult health quality measures
x September 30, 2014: Collect, analyze, and make publicly
available the information reported by the states
The Department of Health and Human Services (HHS) met
the first deadline with a request for comments on an initial set
of measures for the program, published December 30, 2010, in
the Federal Register.
Agency for Healthcare Research and Quality created a subcommittee to identify measures for the program. The initial core set
was comprised of measures submitted by Medicaid medical
directors, current measures from the Centers for Medicare and
Medicaid Services, current measures endorsed by the National
Quality Forum, and measures recommended by the NAC subcommittee.
To assist and focus the prioritization of the measures, the NAC
subcommittee was separated into four workgroups—maternal
and reproductive health, overall adult health, complex health-
care needs, and mental health and substance use. Three criteria
were established to help determine the initial set of measures:
After conducting a review of measures in other programs for
inclusion in the initial core set, the subcommittee developed an
initial set of 51 measures grouped in five sections: prevention
and health promotion, management of acute conditions, man-
agement of chronic conditions, family experiences of care, and
availability. An excerpt illustrating the acute conditions section
appears at right.
