Child Health Measures

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Improving Birth OutcomesHow to Get Involved

The primary purpose of this grant category is to experiment with and/or evaluate the use of new quality measures for children’s health care, including the set of 24 core child health measures released by the Secretary of the U.S. Department of Health and Human Services (HHS) in January 2010 as part of the 2009 CHIPRA legislation. The core measures address the duration of enrollment and health care coverage, preventive and health promotion services, the treatment and management of acute and chronic conditions in children, as well as assessment of families’ experience with health care, the availability of services, and care in the most integrated health settings. It is envisioned that the measures will be used voluntarily by state programs and ultimately provide an estimate of the overall national quality of health care for children.

States participating in the CHIPRA demonstration grants, including Illinois, have been asked to begin to collect data on these measures and/or to design data collection systems for the measures if they are not already in existence. In Illinois, some of the core measures are already collected, analyzed, and reported centrally, and Illinois is committed to reporting on all 24 measures. Illinois will also explore new opportunities to build quality measures into provider reporting and incentive programs, develop and test new measures, and explore the priority areas and utility of the measures for providers themselves.

If you are interested in serving on a panel to help determine measurement and reporting specifications (including reporting, successes and barriers in using data for improvement activities, interest in and feasibility of collecting data on new and not currently reported child health measures, and priorities for the new measures), see the How to Get Involved section.

Initial Core Child Health Measure Set:

Measure Description
Frequency of Ongoing Prenatal Care Percentage of Medicaid deliveries that received the expected number of visits.
Prenatal and Postpartum Care: Timeliness of Prenatal Care The percentage of deliveries of live births that received a timely prenatal care visit.
Percent of live births weighing less than 2,500 grams The measure assesses the number of resident live births less than 2,500 grams as a percent of the number of resident live births in the State reporting period.
Cesarean rate for nulliparous singleton vertex Percentage of women who had a cesarean section among women with first live singleton births [also known as nulliparous term singleton vertex (NTSV) births] at 37 weeks of gestation or later.
Childhood Immunization Status Percentage of 2 year olds who were appropriately immunized. The measure calculates a rate for each vaccine and nine separate combination rates.
Immunizations for Adolescents The percentage of adolescents 13 years of age who were appropriately immunized. The measure calculates a rate for each vaccine and one combination rate.
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Body Mass Index Assessment for Children/Adolescents Percentage of children, 3 through 17 years of age, whose weight is classified based on body mass index percentile for age and gender.
Developmental Screening In the First Three Years of Life Assesses the extent to which children at various ages from 0-36 months were screened for social and emotional development with a standardized, documented tool or set of tools.
Chlamydia Screening Percentage of women 16 through 20 who were identified as sexually active who had at least one test for Chlamydia during the measurement year.
Well-Child Visits in the First 15 Months of Life Percentage of members who received zero, one, two, three, four, five, and six or more well child visits with a primary care practitioner during their first 15 months of life.
Well-Child Visits in the 3rd, 4th, 5th, and 6th Years of Life Percentage of members age 3 through 6 years old who received one or more well-child visits with a primary care practitioner during the measurement year.
Adolescent Well-Care Visit Percentage of members age 12 through 21 years who had at least one comprehensive well-care visit with a primary care practitioner or an OB/GYN practitioner during the measurement year.
Total Eligibles Who Received Preventive Dental Services Total eligible children age 1 to 20 years who received preventive dental services.
Child and Adolescent Access to Primary Care Practitioners Percentage of enrollees who are 12 months through 19 years of age who had a visit with a primary care practitioner (PCP).
Appropriate Testing for Children with Pharyngitis Percentage of patients who were diagnosed with pharyngitis, dispensed an antibiotic, and who received a group A streptococcus test for the episode.
Otitis media with effusion (OME) – avoidance of inappropriate use of systemic antimicrobials in children – ages 2 through 12 Percentage of patients age 2 months through 12 years with a diagnosis of OME who were not prescribed systemic antimicrobials.
Total Eligibles who Received Dental Treatment Services Total eligible children age 1 to 20 years who received dental treatment services.
Ambulatory Care: Emergency Department Visits The number of visits per member per year as a function of all child and adolescent members enrolled and eligible during the measurement year.
Pediatric central-line associated blood stream infections – Neonatal Intensive Care Unit and Pediatric Intensive Care Unit Central line-associated blood stream infections (CLABSI) identified during periods selected for surveillance as a function of the number of central line catheter days selected for surveillance in pediatric and neonatal intensive care units.
Annual number of asthma patients 2 through 20 years old) with one or more asthma-related emergency room visits Asthma emergency department utilization for all children 2 through 20 years of age diagnosed with asthma or treatment with at least 2 short-acting beta adrenergic agents during the measurement year with one or more asthma-related ED visit.
Follow-Up Care for Children Prescribed Attention Deficit Hyperactivity Disorder (ADHD) Medication Percentage of children newly prescribed ADHD medication who had at least 3 follow-up care visits within a 10-month period, one of which was within 30 days from the time the first ADHD medication was dispensed.
Annual Pediatric hemoglobin A1C testing Percentage of pediatric patients with diabetes with a hemoglobin A1c test in a 12-month measurement period.
Follow-up after hospitalization for mental illness Percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental health disorders and who had an outpatient visit, an intensive outpatient encounter, or partial hospitalization with a mental health practitioner.
Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey, 4.0H, Child Version Survey of an individual’s experiences of care.

 

Additional Resources:

Technical Report on the Initial Core Child Health Measure Set:
http://www.cms.gov/MedicaidCHIPQualPrac/Downloads/CHIPRACoreSetTechManual.pdf

Agency for Healthcare Research and Quality (AHRQ) CHIPRA Page:
http://www.ahrq.gov/chipra/

CHIPRA 2011 Annual Report on the Quality of Care for Children in Medicaid and CHIP:
https://www.cms.gov/MedicaidCHIPQualPrac/Downloads/2011SQRC.pdf

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If you have questions or comments about CHIPRA, please contact:

Dru O’Rourke
Manager, Medical Home Initiatives
dorourke@illinoisaap.com
312/733-1026 ext 207

Gwen Smith
IL Project Director, CHIPRA Quality Demonstration
Gwen.Smith@illinois.gov
217-557-5438