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CMS Initial Adult Core Measures

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 organization 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), 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