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.
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 |