The use of national, standardized measures can facilitate reporting, analysis, and comparisons not just within one state, but across states and between Medicaid and commercial insurance. For assessing children’s health services, however, HEDIS measures primarily focused on preventive visits and care delivery processes. While these measures are relevant to special needs populations (including children), they only address a portion of their primary, developmental, mental health, dental, chronic and long-term care needs.
To enhance the relevance of HEDIS measures, the National Committee for Quality Assurance (NCQA) developed with support from The Commonwealth Fund a new set of age appropriate performance measures for comprehensive well child care. CHCS worked with NCQA to ensure that the measures selected reflect greater attention to children’s mental health needs as well as the priorities, capacities, and administrative imperatives of Medicaid. Specifically, CHCS: (1) introduced the newly proposed child health measures to state Medicaid leaders; and (2) helped determine the feasibility of implementation given alignment with state Medicaid child health priorities, purchasing standards, and administrative capacities. With feedback from Medicaid state and health plan leaders, CHCS and NCQA developed recommendations for making these standardized measures most useful to state Medicaid programs.
Ultimately, this project sought to shape NCQA’s child health measurement set into an even more effective tool to help state Medicaid programs better assess the quality of children’s health services. NCQA hopes to have the proposed measures ready for public comment in early 2010 for implementation in HEDIS 2011.