The Children’s Health Insurance Program Reauthorization Act (CHIPRA) legislation required a core set of recommended health care quality measures to be identified for voluntary use by State Medicaid and the Children’s Health Insurance Programs, which together cover almost 40 million American children and adolescents. In a special May-June Supplement to Academic Pediatrics, noted authorities present critical insights into the issues surrounding the initial core set and key concepts for improving children’s health care. In the introductory article, “The Children’s Health Insurance Program Reauthorization Act Quality Measures Initiatives: Moving Forward to Improve Measurement, Care, and Child and Adolescent Outcomes,” AHRQ’s Senior Advisor, Child Health and Quality Improvement Denise Dougherty, Ph.D., and co-authors describe the current environment in children’s health care, noting that children make up 26 percent of the nation’s population and account for 1 in 6 health care dollars, yet only receive 47 percent of the recommended clinical care. Select to access the abstract on PubMed.® A second AHRQ abstract in the special Supplement, “Transforming Children’s Health care Quality and Outcomes-A Not-so-Random Non-Linear Walk Across the Translational Continuum” is also available on PubMed.® A reprint copy of these are available by sending an e-mail to ahrqpubs@ahrq.hhs.gov.
Acad Pediatr. 2011 May-Jun;11(3 Suppl):S1-S10.
The Children's Health Insurance Program Reauthorization Act quality measures initiatives: moving forward to improve measurement, care, and child and adolescent outcomes.
Dougherty D, Schiff J, Mangione-Smith R.
Source
Agency for Healthcare Research and Quality, 540 Gaither Rd, Rockville, Maryland 20850, USA. Denise.Dougherty@ahrq.hhs.gov
Abstract
In 2009, a publicly transparent evidence-informed process responded to the requirement of the Children's Health Insurance Program Reauthorization Act (CHIPRA) legislation to identify an initial core set of recommended children's health care quality measures for voluntary use by Medicaid and the Children's Health Insurance Program, which together cover almost 40 million of America's children and adolescents. Future efforts under CHIPRA will be used to improve and strengthen the initial core set, develop new measures as needed, and post improved core measure sets annually beginning in January 2013. This supplement aims to make available useful information about issues surrounding the initial core set and key concepts for moving forward toward improvement of children's health care quality measures, children's health care quality, and children's health outcomes. The set of articles in this supplement includes a detailed description of how the identification of a balanced, grounded, and parsimonious core set of children's health care quality measures was accomplished by means of an open, public process combined with an evidence-informed evaluation methodology. Additional articles note that Medicaid and Children's Health Insurance Program (CHIP) officials put a high priority on children's health care quality and desire better measures; that publicly insured children are more likely than privately insured children to experience severe, complex chronic conditions and experience poorer quality in some respects; and that some key CHIPRA topics did not yet have valid, feasible measures (eg, availability of services, duration of enrollment and coverage, most integrated health care settings, and some aspects of family experiences of care). Key stakeholders and observers provide commentary noting the unprecedented scope and nature of the CHIPRA legislation as well as noting areas in which the nation still needs to move to improve health care quality, including its measurement. These areas include greater engagement of families and health care providers in the quality measurement and improvement enterprises, collaboration across federal agencies, more emphasis on clinical effectiveness research to enhance the validity of children's health care services and quality measures, and a need to maintain an emphasis on children as the nation expands health care coverage and attention to quality for all populations. This overview also notes areas of future priorities for measure enhancement and development, including inpatient specialty, health outcomes, and a focus on inequity. We and others contributing to this supplement consider the identification of the initial core set to be a significant initial accomplishment under CHIPRA. With sufficient attention to making the measures feasible for use across Medicaid and CHIP programs, and with technical assistance, voluntary use should be facilitated. However, the initial core set is but one step on the road toward improved quality for children. The identification of future challenges and opportunities for measure enhancement will be helpful in setting and implementing a future pediatric quality research agenda.
Published by Elsevier Inc.
PMID:21570012[PubMed - in process]
The Children's Health Insurance Program Reauthoriz... [Acad Pediatr. 2011 May-Jun] - PubMed result
Acad Pediatr. 2011 May-Jun;11(3 Suppl):S91-4.
Transforming children's health care quality and outcomes-a not-so-random non-linear walk across the translational continuum.
Dougherty D, Clancy C.
Source
Agency for Healthcare Research and Quality, 540 Gaither Rd., Rockville Maryland 20850, USA. denise.dougherty@ahrq.hhs.gov
PMID:21570024[PubMed - in process]
Transforming children's health care quality and ou... [Acad Pediatr. 2011 May-Jun] - PubMed result
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