Measuring Quality in Pediatrics: Florida’s Early Experiences with the CHIPRA Core Measure Set
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Enacted in 2009, the Children’s Health Insurance Program Reauthorization Act (CHIPRA) aims, among other things, to increase state’s accountability for providing quality health care to all children in the United States. Although it is important for states to report on the measures, learning from their successes and failures is critical in producing the measures so that states will be prepared for future regulations. Florida covered roughly 2.59 million children in 2010. Administrative, medical record, registry, and survey data were used to report on 20 of the 24 CHIPRA core measures. Technical specifications from the Centers for Medicare and Medicaid Services were used. Approximately 10 months were needed to identify, collect, safeguard, and process the required data. Florida was able to build on its past experiences with performance measurement reporting and surveying. Conducting medical record reviews at the state level and producing measures that required registry data proved to be challenging. Although Florida was successful in its first year of reporting the CHIPRA core measures, certain populations were not included in some of the measures. The next phase of Florida’s CHIPRA project will focus on developing and implementing a dissemination plan and creating opportunities to improve the measures. Florida has made significant progress in the early phases of reporting the CHIPRA measures. As Florida gains more experience in reporting the measures, and results from other states are released, it will be easier to put the statewide measure results into context. Once meaningful comparisons can be made, Florida will be able to better plan for the future of child health and health outcomes.
KeywordsPediatrics Quality Measurement Medicaid CHIP
This document was developed under grant CFDA 93.767 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services. However, these contents do not necessarily represent the policy of the US Department of Health and Human Services, and you should not assume endorsement by the Federal Government.
Conflict of interest
- 1.Federal Register Notice 2474-NC-CMS. Request for Public Comment on Initial, Recommended Core Set of Children’s Healthcare Quality Measures for Voluntary use by Medicaid and CHIP Programs. Available at: http://www.gpo.gov/fdsys/pkg/FR-2009-12-29/html/E9-30802.htm. Accessed 18 June 2013.
- 3.Florida KidCare Coordinating Council. (2011). Annual report and recommendations. Available at: http://www.floridakidcare.org/council.html. Accessed 18 June 2013.
- 4.Center for Medicaid and CHIP Services. (2011). Initial core set of children’s health care quality measures: Technical specifications and resource manual for federal Fiscal year 2011 reporting. Updated December 2011. Centers for Medicare and Medicaid Services. http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/Downloads/InitialCoreSetResouceManual.pdf. Accessed Nov 8 2012.
- 5.National Commission on Quality Assurance. (2007). HEDIS ® technical specifications, 2008. Washington, DC: National Commission on Quality Assurance.Google Scholar
- 6.Florida Agency for Health Care Administration. Health plan report guide. Available at: http://www.fdhc.state.fl.us/mchq/managed_health_care/mhmo/docs/contract/1215_Contract/Report%20Guides/Jan2013/Report_Guide_FINAL_effective_01-1-2013.pdf. Accessed 8 Nov 2012.
- 9.Quality of Care External Quality Review. (EQR). Medicaid.gov. Available at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/Quality-of-Care-External-Quality-Review.html. Accessed 31 Oct 2012.
- 10.Florida Department of Health. Floridashealth.com. Available at: http://www.doh.state.fl.us/. Accessed 8 Nov 2012.
- 11.Free Statewide Immunization Registry. Florida Shots website. Available at: http://www.flshots.com/. Accessed 31 Oct 2012.
- 12.CHAPS. Agency for healthcare research and quality website. Available at: https://www.cahps.ahrq.gov/. Accessed 31 Oct 2012.
- 13.CAHPS Clinician & Group Surveys. Supplemental items for the child surveys 1.1. Available at: https://cahps.ahrq.gov/clinician_group/cgsurvey/childsupplementalitemseng1-1.pdf. Accessed 5 Nov 2012.
- 15.National Committee for Quality Assurance. (2010). HEDIS 2011, Vol. 2: Technical specifications for health plans. Washington DC: National Committee for Quality Assurance.Google Scholar
- 19.Pediatric Quality Measures Program (PQMP) Centers of Excellent Grant Awards. Agency for healthcare research and quality website. Available at: http://www.ahrq.gov/chipra/pqmpfact.htm. Accessed 8 Nov 2012.
- 22.Friedberg, M. W., & Damberg, C. L. (2011). Methodological considerations in generating provider performance scores for use in public reporting: A guide for community quality collaboratives. Agency for Healthcare Research and Quality Website. Available at: http://www.ahrq.gov/qual/value/perfscoresmethods/. Accessed 13 Nov 2012.
- 25.Friedberg, M. W., SteelFisher, G. K., Karp, M., & Schneider, E. C. (2010). Physician groups’ use of data from patient experience surveys. Journal of General Internal Medicine. Available at http://www.commonwealthfund.org/Publications/In-the-Literature/2010/Dec/Physician-Groups-Use-of-Data-from-Patient-Experience-Surveys.aspx#citation. Accessed 13 Nov 2012.
- 29.Knapp, C., Wang, H., Baker, K., & Kaufmann, M. (2012). Pediatric performance Measurement in Florida’s CHIPRA demonstration grant, contract period 2011. Gainesville, FL: Institute for Child Health Policy.Google Scholar
- 30.March of Dimes. March for Babies website. Available at: http://www.marchforbabies.org/. Accessed 8 Nov 2012.
- 31.The Family Café website. Available at: http://familycafe.net/index.php?option=com_content&view=featured&Itemid=62. Accessed 8 Nov 2012.