Children's Health Insurance Program Reauthorization Act (CHIPRA)
CHIPRA - What's New
CHIPRA Measures Program: Quality Measures
Children's health care quality measures funded by CHIPRA.
Children's health care quality measures funded by CHIPRA.
The first Implementation Guide is now available. It focuses on stakeholder engagement for child health care quality improvement.
Ten Evaluation Highlights are now available that describe how demonstration States are working to improve children's health care quality.
CHIPRA Children's Health Care Quality Measurement and Improvement Activities
The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 was signed into law by President Obama in January 2009. Since that time, the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS) have been working together to implement selected provisions of the legislation related to children's health care quality.Title IV of CHIPRA promises a new day for children's health care quality, especially for those 45 million children covered by Medicaid and CHIP programs. We are pleased to share the latest information about how our work is progressing and to provide key stakeholders an opportunity to share their views on this critical endeavor.
Please send comments to CHIPRAqualitymeasures@ahrq.hhs.gov.
Contents
OverviewImproving the Initial Core Set: The CHIPRA Pediatric Quality Measures Program
National Evaluation of the CHIPRA Quality Demonstration Grant Program
Children's EHR Format
Institute of Medicine Report
Identification of the Initial Core Set of Children's Health Care Quality Measures
More AHRQ Resources
Centers for Medicare & Medicaid Services
Archived Materials
Overview
The Agency for Healthcare Research and Quality (AHRQ) is working in collaboration with CMS, the CHIPRA Federal Quality Workgroup, and external experts to fulfill a number of requirements under Title IV of CHIPRA:- Identify an initial core set of children's health care quality measures for voluntary use by Medicaid and CHIP programs (select for a list of final, posted measures and archived materials).
- Implement the CHIPRA Pediatric Quality Measures Program using grants and contracts. The PQMP will contribute to the CHIPRA-required identification of improved core children's health care quality measures for use by Medicaid and CHIP and other public and private programs, providers, plans, and patients.
- Evaluate CMS's Quality Demonstration project awards and create a Model Children's Electronic Health Record Format.
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Improving the Initial Core Set: The CHIPRA Pediatric Quality Measures Program
As a followup to identifying the initial core measure set of children's health care quality measures, CHIPRA required establishment of a Pediatric Quality Measures Program (PQMP). CHIPRA Charge for the PQMP:- Develop future enhanced and improved Child Core Sets of measures.
- Provide for development of new measures for use by:
- Medicaid/CHIP programs.
- Other public and private programs, plans, providers, and patients.
As part of the PQMP, AHRQ and CMS awarded cooperative agreement grants to 7 CHIPRA Pediatric Healthcare Quality Measures Program Centers of Excellence (COEs).
All measures developed by these COEs are publicly available for non-commercial use.
Refer to:
- COE-developed children's health care quality measures. The list is updated regularly as the COEs submit additional measures.
- Topics of measures in development by COEs.
- CHIPRA PQMP-related journal publications.
- Fact sheets with additional details will be provided as they become available.
Select for the candidate measure submission form (CPCF) used by COEs to submit measures and by the Subcommittee on Quality Measures for Children's Healthcare (SNAC) to assess submitted measures. The CPCF was approved by OMB in December 2012. Select for the Federal Register announcement for public nomination of measures.
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National Evaluation of the CHIPRA Quality Demonstration Grant Program
In February 2010, CMS awarded grants to 10 States to identify effective, replicable strategies to enhance quality of care and improve care delivery for children enrolled in Medicaid and CHIP. Through partnerships and collaboration, 18 States are implementing 51 projects in five general categories: the use of quality measures, health information technology applications, provider-based delivery models, use of a model format for pediatric electronic health records, and other innovative approaches to improve quality.AHRQ is leading the national evaluation of this program. Select for more information about the National Evaluation of the Quality Demonstration Grant Program.
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Children's EHR Format
The Children's EHR Format was authorized by the 2009 Children's Health Insurance Program Reauthorization Act (CHIPRA) and developed by AHRQ in close collaboration with CMS. The Format was developed to bridge the gap between the functionality present in most EHRs currently available and the functionality that would more optimally support the care of children. Specifically, the Format provides information to EHR system developers and others about critical functionality, data elements, and other requirements that need to be present in an EHR system to address health care needs specific to children, especially those enrolled in Medicaid or the Children's Health Insurance Program (CHIP).For more information about the Children's EHR Format or to access the Format, go tohttp://healthit.ahrq.gov/ChildehrFormat.
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Institute of Medicine Report
The CHIPRA legislation called for the Institute of Medicine (IOM) to study and prepare a report on efforts to measure child health status
and the quality of health care for children across the pediatric age span.Return to Contents
Identification of the Initial Core Set of Children's Health Care Quality Measures
CHIPRA required that an initial core set of children's health care quality measures for voluntary use by Medicaid and CHIP programs be posted for public comment by January 1, 2010. The legislation required that the measure set:- Be drawn from measures already in use to measure children's health care quality.
- Cover:
- A full array of health care quality domains.
- A broad array of health care services affecting children.
- Children of all ages, all children's health care settings and providers.
- Be evidence-based.
- Be understandable to families.
- Allow identification of disparities by race, ethnicity, socioeconomic status, and special health care need status.
AHRQ organized a publicly transparent, evidence-informed process to identify the initial core set of measures for consideration by CMS and the Secretary of HHS. The SNAC submitted a report to AHRQ (select for the SNAC Reportdetailing their work). The measure set was posted for public comment by the legislative deadline. In February 2011, CMS posted technical specifications for the measures to be used by State programs.
At AHRQ's request, SNAC Co-Chair Rita Mangione-Smith prepared a thoughtful overview and evaluation of the Subcommittee's work in identifying the initial core set of quality measures, including a number of "lessons learned" along the way that could benefit similar future endeavors. The report, Lessons Learned from the Process Used to Identify an Initial Core Quality Measure Set for Children's Health Care in Medicaid and CHIP, is now available.
Additional reports, meeting transcripts, and other documents pertaining to the SNAC and the process of identifying the initial core set of measures are available. (Select Archived Materials.)
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More AHRQ Resources
Child Health Care Quality, Medicaid, and CHIP- Child & Adolescent Health
- Child Health Insurance Research Initiative (CHIRI™)
- Model Children's EHR Format: Frequently Asked Questions
- National Healthcare Quality Report and National Healthcare Disparities Reports
- National Quality Measures ClearinghouseTM (NQMC)
- Pediatric Quality Indicators
- Consumer Assessment of Healthcare Providers and Systems (CAHPS®)
- MEPS Topics: Children's Health; reports and data files from AHRQ's Medical Expenditure Panel Survey
Centers for Medicare & Medicaid Services
- CMS CHIPRA Web site
Second Annual Multi-State Health IT Collaborative for E-Health Conference, February 8-9, 2010
Handouts and an audio recording of the HITECH conference call are available for download athttp://www.cms.gov/EHRIncentivePrograms under "Related Links Inside CMS."
Page last reviewed October 2014
Internet Citation: Children's Health Insurance Program Reauthorization Act (CHIPRA). October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/policymakers/chipra/index.html
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