The Health and Human Services Department has finalized its initial core set of health quality measures for adults eligible for Medicaid for voluntary use by states. The measures would also be used by the health insurers and managed care organizations that contract with Medicaid to provide coverage for low-income individuals and families.
The measures include smoking cessation prevention and assistance, breast cancer screenings, controlling high blood pressure and management of other chronic conditions and tracking family experience of care through surveys.
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The measures also promote care coordination in transitions between care settings with a summary record transmitted to a patient's provider, according to the announcement in the Jan. 4 Federal Register. Some of the measures rely on electronic health records (EHRs) and other health IT.
HHS published the proposed measures a year ago for comments, after which HHS cut the number of core measures in half from 51 to 26.
Voluntary reporting does not begin until Dec. 2013. The Centers for Medicare and Medicaid Services will release technical descriptions of the measures by September 2012 and provide details by January 2013 about the standard format that participating state Medicaid programs will use to submit their data. HHS will publish later in 2014 analysis of the measure data for quality.
The health reform law called for identifying the initial core set of quality measures by January 2012, which "is an important first step in an overall strategy to encourage and enhance quality improvement," HHS said in the final notice about the measures.
"States that chose to collect the initial core set will be better positioned to measure their performance and develop action plans to achieve the three part aims of better care, healthier people and affordable care," HHS said.
Most of the 26 measures are already used in federal reporting programs, including CMS' EHR incentive program; National Committee for Quality Assurance accreditation; the Medicare Physician Quality Reporting System; and the Health Employer Data and Information Set (HEDIS).