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CMS Initial Adult Core Measures

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The following measures have been identified by the Centers for Medicare and Medicaid Services or CMS (not DHCS) as the Initial Adult Core Measures.  Each measure that is defined by the National Quality Forum or NQF (not DHCS) has a number which is shown below. The numbers are linked to the measures on the NQF website.  The Measure Steward refers to the orginization that is responsible for providing the required measure information for the measure maintenance process that occurs approximately every three years and is responsible for making the necessary updates to the measure and for informing NQF about any changes that are made to the measure on an annual basis.  Each candidate measure or set of measures will have a measure steward who will assume responsibility for the submission of the measure for potential endorsement of NQF.   

Measure Stewards included below are outside of the Department of Health Care Services (DHCS): the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ), American Medical Association (AMA-PCPI), and the Health Services Advisory Group (HSAG).   

For each measure we have identified the programs within DHCS that use and report that measure.  Programs that currently use or plan to use the measures include the Adult Medicaid Quality Grant (AMQG), the Managed Care Plans (MCPs) and the Coordinated Care Initiative CalMediconnect.

NQF

Measure Steward

Measure Name

DHCS Reports

0039

NCQA

Flu Shots for Adults Ages 50-64 (Collected as part of HEDIS CAHPS Supplemental Survey)

 

N/A

NCQA

Adult BMI Assessment

 

 

0031 (PDF)

NCQA

Breast Cancer Screening

CalMediconnect

0032 

NCQA 

Cervical Cancer Screening 

 

AMQG, MCP

0027

NCQA

Medical Assistance With Smoking and Tobacco Use Cessation (Collected as part of HEDIS CAHPS Supplemental Survey)

 

 

 

0418

CMS

Screening for Clinical Depression and Follow-Up Plan

CalMediconnect

1768

NCQA

Plan All-Cause Readmission

AMQG, MCP, CalMediconnect

0272

AHRQ

PQI 01: Diabetes, Short-term Complications Admission Rate

AMQG

0275

AHRQ

PQI 05: Chronic Obstructive Pulmonary Disease (COPD) Admission Rate

AMQG

0277

AHRQ

PQI 08: Congestive Heart Failure Admission Rate

AMQG

0283

AHRQ

PQI 15: Adult Asthma Admission Rate

AMQG

0033

NCQA

Chlamydia Screening in Women age 21-24 (same as CHIPRA core measure, however, the State would report on the adult age group)

AMQG

0576

NCQA

Follow-Up After Hospitalization for Mental Illness

CalMediconnect

0469

HCA, TJC

PC-01: Elective Delivery

AMQG

0476

Prov/CWISH/NPIC/QAS/TJC

PC-03 Antenatal Steroids

AMQG

0403 (PDF)

NCQA

Annual HIV/AIDS medical visit

AMQG

0018 

NCQA

Controlling High Blood Pressure 

MCP, CalMediconnect

0063  

 

NCQA

Comprehensive Diabetes Care: LDL-C Screening

AMQG, MCP, CalMediconnect

0057

NCQA

Comprehensive Diabetes Care: Hemoglobin A1c Testing

AMQG, MCP, CalMediconnect

0105

NCQA

Antidepressant Medication Management

AMQG, CalMediconnect

N/A

CMS-QMHAG

Adherence to Antipsychotics for Individuals with Schizophrenia

AMQG

0021 (PDF)

NCQA

Annual Monitoring for Patients on Persistent Medications  

 

AMQG, MCP

0006 & 0007

AHRQ & NCQA

CAHPS Health Plan Survey v 4.0 - Adult Questionnaire with CAHPS Health Plan Survey v 4.0H - NCQA Supplemental

 

 

 

648

AMA-PCPI

Care Transition – Transition Record Transmitted to Health care Professional

CalMediconnect

 

 

0004

NCQA

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

CalMediconnect

 

 

1391

NCQA

Prenatal and Postpartum Care: Postpartum Care Rate

AMQG, MCP

Last modified on: 9/26/2014 8:55 AM