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ACAP SUBMITS COMMENTS ON CHIPRA QUALITY MEASURES
On December 29th, CMS in
conjunction with the Agency for Health Care Quality, issued for
public comment the proposed initial core set of children's
health care quality measures for voluntary use by State programs
administered under titles XIX and XXI of the Social Security
Act. The proposed measures were developed in accordance with the
Children's Health Insurance Program Reauthorization Act of 2009
(Pub. L. 111-3). The notice included a total of 24 measures,
including a number of existing HEDIS measures.
On February 19th, ACAP hosted a call to discuss the proposed
measures. Comments were submitted to AHRQ . The full text of the
comments can be found on the
ACAP website.
COLORADO ACCESS’ DIRECTOR OF CONSUMER AND FAMILY AFFAIRS WORKS
TO GIVE CONSUMERS A GREATER VOICE
Claudine McDonald, Director of
Consumer and Family Affairs at Colorado Access, was nominated
for the ACAP Making a Difference Award. Claudine has worked at
the health plan for 12 years. For the last 3 years, her work to
develop a very successful consumer advisory board structure and
outreach strategy has enabled Colorado Access to give their
consumers a greater voice in their healthcare and provided them
with a variety of tools to better manage their own health.
While Colorado Access has advisory boards for all our lines of
business, their behavioral health program, Access Behavioral
Care, has members that are frequently hard to engage and
frequently feel left out of all systems of care. The work
Claudine has done to outreach and engage this group of members
has been remarkable. When she took over responsibility for this
advisory group, Colorado Access had a group of 5-8 members who
regularly showed up for the meetings but it was the same group
of people and their degree of engagement in the meeting was
somewhat lacking. Since Claudine has the program under her
control, Colorado Access regularly has 50-60 attendees at each
meeting, many of whom have never attended any of the health plan
events in the past. This group is very vocal about their wants
and needs and their feedback has enabled Colorado Access to make
many significant changes in their program to better serve them.
Claudine and her staff have also developed a variety of new
materials focused on this population that include a member
newsletter, featuring a column written by the chair of the
advisory committee, a member himself, as well as information
about local events of interest and self help suggestions.
Colorado Access regularly gets feedback from members about how
much they like working with Claudine and how comfortable they
feel with her. Her contributions with this sometimes difficult
community have allowed Colorado Access to better engage with all
their members and to enhance the program to better serve some of
their most vulnerable members.
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ACAP PARTICIPATES IN AHRQ EXPERT PANEL ON CHILD HEALTH MEASURE
CRITERIA
The Agency for Healthcare
Research and Quality, working in close partnership with the
Centers for Medicare and Medicaid Services in response to
requirements of the Children's Health Insurance Program
Reauthorization Act of 2009 (CHIPRA, Public Law 111-3), plans to
award cooperative agreements designed to advance and improve
pediatric healthcare quality measures. The goal of the Pediatric
healthcare Quality Measurement Program (PQMP) is to produce an
improved core set of children's healthcare quality measures for
use by public and private programs, health insurers, providers
and patients, by January 1, 2013, as required by CHIPRA.
To facilitate creation of an improved, standardized core set,
awardees will be required to use a standardized consensus set of
measure criteria. These include requirements for measures that:
are evidence-based; contribute to identifying disparities by
race, ethnicity, socioeconomic status, and special health care
needs status; suitable for use across public and private
programs, providers, and patients; and are understandable by
providers and patients.
On February 24th and 25th, the AHRQ held an Expert Panel meeting
to obtain input into the appropriate measure criteria. Deborah
Kilstein, ACAP’s Director of Quality Management and Operational
Support attended the meeting at the invitation of AHRQ.
ACAP TO SUBMIT COMMENTS TO NCQA ON HEDIS 2011
NCQA is currently inviting
parties to comment on proposed new measures and changes to
existing measures for HEDIS® 2011. The comments must be
submitted by March 22, 2010. Detailed information on the changes
and the public comment submission process is available
here.
In advance of submitting comments, ACAP will be hosting a call
on March 18th at 3pm ET for our member health plans to discuss
the proposed changes and to receive member input.
A proposed new measure to HEDIS 2011 will be introduced:
- Plan
All-Cause Readmissions (previously known as Inpatient
Readmissions)
Revisions to following existing
HEDIS measures (listed below) will be available for review and
comment:
- Ambulatory Care
- Frequency of Selected
Procedures
- Language Diversity of
Membership
- Race/Ethnicity Diversity of
Membership
- Spirometry Testing in the
Assessment and Diagnosis of COPD
- Relative Resource Use
measures - Pharmacy Update
- Relative Resource Use
measures - Risk Adjustment Update
- Relative Resource Use
measures - Utilization Update
- Relative Resource Use
Diabetes and Cardio - Utilization Update
The following proposed measures
to retire from HEDIS 2011 will also be available for review:
- Inpatient Utilization -
Non-acute Care
- Outpatient Drug Utilization
ACAP HOSTS JOINT ROUNDTABLE CALL ON ANTIPSYCHOTICS
On March 5th, ACAP held a joint
Roundtable call for CMOs, Quality Directors and Pharmacy
Managers. The focus of the call was the use of atypical
antipsychotics, especially in children. Dr. Stephen Crystal,
Director, Center for Pharmacotherapy, Chronic Disease
Management, and Outcomes, and Center for Education and Research
on Mental Health Therapeutics, at Rutgers University and other
members of his research team participated in the ACAP Roundtable
call. Dr Crystal and his team discussed the findings outlined in
the July 2009 article in Health Affairs entitled Broadened
Use Of Atypical Antipsychotics: Safety, Effectiveness, And
Policy Challenges. This report was also highlighted in the
December 11, 2009 NY Times article on the high use of
antipsychotic drugs for children on Medicaid.
In addition, working with a national group of experts, and state
mental health and Medicaid staff from NY, California and TX, Dr
Crystal and his team also developed a Clinician’s Toolkit to be
used in quality improvement and clinician education programs.
This toolkit was also discussed on the call.
FIRST ACAP NETWORKING CALL ON CARE TRANSITIONS
On March 3rd, staff from a dozen
ACAP health plans participated in the first Quality Networking
call on Care Transitions. Unlike the Roundtable calls that have
a more structured agenda, the purpose of the Networking calls is
to allow plan to plan sharing on a quarterly basis around a
particular topic.
This inaugural call focused on foundational models for care
transitions, a September 2009 California HealthCare Foundation
report entitled Homeward Bound: Nine Patient-Centered
Programs Cut Readmissions, a National Transitions of Care
Coalition checklist for Transitions of Care, and a round robin
discussion on what ACAP health plans are doing to address the
issue of improving transitions in care.
ACAP PARTICIPATES IN BRIEFING FOR RELEASE OF REPORT ON ASTHMA
On February 23rd, a briefing was
held at the Capital Visitor Center in Washington, DC on a new
report from George Washington University that provides an
evidence–based, national plan to improve life for the one in
seven children with asthma and their parents. The report,
“Changing pO2licy: The Elements for Improving Childhood Asthma
Outcomes,” is supported by the Merck Childhood Asthma Network,
Inc. (MCAN) and RCHN Community Health Foundation (RCHN).
The program included an overview of the report from lead author,
Anne Markus, JD, PhD, MHS including startling new childhood
asthma data with a focus on coverage, access, health
disparities, health information, and environmental and public
health; the five essential elements that can improve childhood
asthma outcomes; and concrete recommendations affecting health
insurance, health care, monitoring and surveillance, health
information and environmental health. The briefing concluded
with an expert panel discussion moderated by Sara Rosenbaum, JD,
Study co-author and Hirsh Professor and Chair, GW School of
Public Health and Health Services Department of Health Policy
which included Deborah Kilstein, ACAP Director of Quality
Management and Operational Support as one of the panelist. The
briefing was repeated during a national webinar held on March
4th.
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