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CMS Initial Children 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 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:

  • National Committee for Quality Assurance (NCQA)
  • Centers for Disease Control and Prevention (CDC)
  • California Maternal Quality Care Collaborative (CMQCC)
  • Child and Adolescent Health Measurement Initiative (CAHMI)
  • American Medical Association – Physician Consortium for Performance Improvement® (AMA-PCPI)

For each measure, we have identified the programs within DHCS that use and report that measure. The program that currently use or plan to use the measures include the Managed Care Plans (MCPs) and Healthy Families.

CMS Initial Core Set of Health Care Quality Measures for Children in Medicaid and CHIP

NQF # Measure Steward Measure Name California Reports
1517 NCQA Prenatal and Postpartum Care: Timeliness of Prenatal Care MCP
1391 NCQA Frequency of Ongoing Prenatal Care
1382 CDC Percentage of Live Births Weighing less than 2,500 Grams
0471 California Maternal Quality Care Collaborative Cesarean Rate for Nulliparous Singleton Vertex
0038 NCQA Childhood Immunization Status MCP, Healthy Families
1407 NCQA Immunizations for Adolescents MCP
0024 NCQA Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Body Mass Index Assessment for Children/Adolescents MCP
1448 CAHMI and NCQA Developmental Screening in the First Three Years of Life
0033 NCQA Chlamydia Screening in Women Healthy Families
1392 NCQA Well-Child Visits in the First 15 Months of Life Healthy Families
1516 NCQA Well-Child Visits in the 3rd, 4th, 5th, and 6th Years of Life MCP, Healthy Families
NA NCQA Adolescent Well-Care Visit Healthy Families
NA CMS Total Eligibles Who Received Preventive Dental Services (ages 1-20)
NA NCQA Child and Adolescent Access to Primary Care Practitioners MCP, Healthy Families
0002 NCQA Appropriate Testing for Children with Pharyngitis
0657 AMA-PCPI Otitis Media with Effusion (OME)–Avoidance of Inappropriate Use of Systemic Antimicrobials
NA CMS Total Eligibles Who Received Dental Treatment Services (ages 1-20)
NA NCQA Ambulatory Care: Emergency Department Visits
0139 CDC Pediatric Central-line Associated Bloodstream Infections–Neonatal Intensive Care Unit and Pediatric Intensive Care Unit
1381 Alabama Medicaid Annual Percentage of Asthma Patients with One or More Asthma-related Emergency Room Visits (ages 2-20)
0108 NCQA Follow-Up Care for Children Prescribed Attention Deficit Hyperactivity Disorder (ADHD) Medication
0060 NCQA Annual Pediatric Hemoglobin A1C Testing
0576 NCQA Follow-up After Hospitalization for Mental Illness
NA NCQA CAHPS® 4.0H (child version including Medicaid and children with chronic conditions supplemental items)