Updates to Common Measure Set focus on pediatrics
In 2014 Washington became one of the first states to agree upon a common measure set for health care quality and cost. The impetus was to align measurement efforts across a wide variety of organizations, send a common message about performance accountability and create the basis for purchasing health care based on better value, i.e., high quality at an affordable price.
Development of the Washington State Common Measure Set for Health Care Quality and Cost was facilitated by the Alliance at the request of the Washington State Health Care Authority (HCA). The initial version included 52 measures, and the results were used to inform health care purchasing by public entities, such as state, county and city government, as well as private companies. Because measurement alone will not transform our health care system, the Common Measure Set was designed to be actionable, and the HCA incorporated the Common Measure Set into its contracts with health plans and provider organizations.
That version of the Common Measure Set was a “starter set,” intended to be a first iteration that evolved over time. Because the work of improving health and health care is ongoing, the Common Measure Set adapts to changing conditions to include other priority issues and sources of data.
The Washington State Performance Measures Coordinating Committee met last December to review recommendations from the Pediatric Measures Ad Hoc Work Group, a group of subject matter experts that were specially convened and charged with reviewing pediatric-related measures and making recommendations regarding which measures to keep, remove and/or replace, or add.
The Work Group’s final recommendations included adding three new quality measures, modifying one measure, and removing one measure that was redundant with another. These recommendations were unanimously approved by the Committee and implemented in the 2017 Common Measure Set.
The health of Washington’s children has never been of greater importance, and the focus on these pediatric measures reflects priority areas of care. The Common Measure Set is an important element in the state’s ambitious Healthier Washington initiative, which strives to make the Triple Aim—better health, better care and lower cost—a reality in Washington. Most pediatric-related measures from the Common Measure Set are also included as key performance measures in the Medicaid Transformation Demonstration. Timely and high quality pediatric care contributes to better health and development, and prioritizing these measures will help more Washington children have a healthy start to life.
A very broad group of multi-stakeholders from across the state support this work. We are grateful for their input and deep knowledge that helps keep the Statewide Common Measure Set current and actionable.
The following is a full list of changes to the pediatric-related measures in the 2017 Washington State Common Measure Set (Note: The abbreviations next to measure names are part of the NCQA HEDIS naming convention and are used here to clarify a particular version of the measure.)
A. Keep the following 12 quality measures (already approved for the Common Measure Set) that relate to a pediatric-only population (ages 17 and younger) or a mixed pediatric-adult population:
1. Childhood Immunization Status – Combination 10 (CIS)
2. Immunizations for Adolescents (IMA)
3. Oral Health – Primary Caries Prevention in Primary Care
4. Children and Adolescent’s Access to Primary Care Practitioners (CAP)
5. Appropriate Testing for Children with Pharyngitis (CWP)
6. Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)
7. Well Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (W34)
8. Immunization for Influenza
9. Chlamydia Screening in Women (CHL)
10. Mental Health Service Penetration
11. Substance Use Disorder Service Penetration
12. Follow-up After Hospitalization for Mental Illness (FUH)
B. Keep a 13th quality measure (already approved for the Common Measure Set) but with the following modification:
13. Medication Management for People with Asthma (MMA) – Report 75% adherence (rather than 50% adherence)
C. Add three new quality measures that relate to the pediatric-only population:
14. Well Child Visits in the First Fifteen Months of Life (W15)
15. Follow-up Care for Children Prescribed ADHD Medication (ADD)
16. Audiological Evaluation No Later Than 3 Months of Age
D. Remove one measure from the Common Measure Set:
- Human Papillomavirus Vaccine for Female Adolescents by Age 13
This measure was removed from the Common Measure Set because the measure was retired by NCQA, effective 2017. Instead, HPV vaccination is now included as part of the Immunization for Adolescents (IMA) measure.