Louisiana Medicaid’s Deep Dive on Quality: Engagement ... · Initial Quality measures survey to...
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Louisiana Medicaid’s Deep Dive on Quality: Engagement Process and Proposed Measures 1 Marcus Bachhuber, MD, MS, FACP, Medicaid Chief Medical Officer Pooja Mehta, MD, MSHP, FACOG, Medicaid Clinical Innovation Officer May 17, 2019
Transcript of Louisiana Medicaid’s Deep Dive on Quality: Engagement ... · Initial Quality measures survey to...
Louisiana Medicaid’s Deep Dive on Quality:
Engagement Process and Proposed Measures
1
Marcus Bachhuber, MD, MS, FACP,
Medicaid Chief Medical Officer
Pooja Mehta, MD, MSHP, FACOG,
Medicaid Clinical Innovation Officer
May 17, 2019
LDH Process for Quality Outreach
2
Medicaid Quality Committee and
Subcommittees Members
One-On-One Meetings with Committee Members,
Providers and Stakeholders
Medicaid Quality Public Forums held in Alexandria, Baton Rouge, New Orleans, and Shreveport throughout
February
Electronic Quality Measures Survey to Quality Committee
and Several Providers
LDH Secretary and all Sister Agencies within LDH
3
Initial Feedback: Internal
Engagement with Secretary and all sister agencies
Stakeholder interviews with medical directors/quality teams
• NC, OH, TN, WA, MN, OR
In-depth reviews of available measure sets:
• NCQA-HEDIS
• NQF
• CMS
• AHRQ
• Joint Commission
• RWJ/Buying Value
Consultation with CMS
Current MCO quality performance4
Initial Feedback: External
Initial Quality measures survey to gain feedback on what measures
should be maintained, ideas for new inclusion, and priorities for
incentivized status in draft measure set
• Medicaid Quality Committee members, provider stakeholders,
subcommittee chairs
• Survey closed November 2, 2018
• 35 individual responses received (30% response rate)
Draft Quality Strategy framework and measures reviewed with Quality
Committee Subcommittee chairs/subcommittees in second round
5
Quality Public Forums 2019Alexandria Baton Rouge New Orleans Shreveport Total
# Attendees 35 36 57 39 167
# Survey Responses 24 30 41 35 130
6
New Orleans 34%
Shreveport23%
Baton Rouge22%
Alexandria21%
Attendance
New Orleans 32%
Shreveport26%
Baton Rouge23%
Alexandria19%
Survey responses 78%
response rate
Quality Public Forum Survey Respondents
Industry # %
Member or advocate 3 2.11
Direct Patient Care 34 23.94
Managed Care
Organization 20 14.08
Hospital/Health Care
System 25 17.6
Professional Organization 16 11.26
Other 44 30.98
TOTAL 142
7
Member/ Advocate
2%
Direct Patient Care 24%
Employee or Sub-contractor of a managed Care Organization …
Hospital of Health Care
System 18%
Professional Organization
11%
Other 31%
*Some respondents selected more than 1
representation. Therefore, totals may not match previous slide.
Forum Survey Respondents by Region and Industry
8
New Orleans Shreveport Baton Rouge Alexandria
Member or advocate 2 4.30% 1 2.60% 0 0% 0 0%
Direct Patient Care 18 39.10% 10 25.60% 3 9.10% 3 12.50%
Managed Care Organization 5 10.90% 6 15.40% 6 18.20% 3 12.50%
Hospital/Health Care System 6 13% 4 10.30% 9 27.30% 6 25%
Professional Organization 3 6.50% 3 7.70% 6 18.20% 4 16.70%
Other 12 26.10% 15 38.50% 9 27.30% 8 33.30%
TOTAL 46 39 33 24
*Some respondents selected more than 1 representation. Therefore, totals may not match previous slide.
Adult Incentivized Measures- Votes
9
Controlling High Blood Pressure 23
Adult Access to Preventive/Ambulatory
Services 18
Cervical Cancer Screening 17
HIV Screening 17
Breast Cancer Screening 16
Comprehensive Diabetes Care 15
Colorectal Cancer Screening 12
Flu Vaccinations for Adults Ages 18 to 64 12
HIV Viral Load Suppression 11
Medical Assistance With Smoking and
Tobacco Use Cessation 11
Chlamydia Screening in Women-Total 10
Adult Body Mass Index Assessment 9
HCV Screening 8
Diabetes Short-Term Complications
Admission Rate 7
Heart Failure Admission Rate 6
Avoidance of Antibiotic Treatment in Adults
With Acute Bronchitis 5
Statin Therapy for Patients with
Cardiovascular Disease 4
Use of Imaging Studies for Low Back Pain 4
Asthma in Younger Adults Admission Rate 2
Chronic Obstructive Pulmonary Disease or
Asthma in Older Adults Admission Rate 2
Measure Votes
23
1817 17
1615
12 1211 11
109
87
65
4 4
2 2
0
5
10
15
20
25
Top 3: Incentivized Controlling High Blood Pressure
Adult Access to Preventive/Ambulatory Services
Cervical Cancer Screening
Adult Monitored Measures- Votes
Controlling High Blood Pressure 28
Breast Cancer Screening 27
Adult Access to Preventive/Ambulatory Services24
Adult Body Mass Index Assessment24
Comprehensive Diabetes Care24
Flu Vaccinations for Adults Ages 18 to 6424
Medical Assistance With Smoking and Tobacco
Use Cessation 24
Colorectal Cancer Screening22
Asthma in Younger Adults Admission Rate 21
HCV Screening20
HIV Screening 20
Cervical Cancer Screening 19
Chronic Obstructive Pulmonary Disease or
Asthma in Older Adults Admission Rate 19
Statin Therapy for Patients with Cardiovascular
Disease 19
Use of Imaging Studies for Low Back Pain19
Chlamydia Screening in Women-Total18
HIV Viral Load Suppression 18
Diabetes Short-Term Complications Admission
Rate 17
Avoidance of Antibiotic Treatment in Adults With
Acute Bronchitis 16
Heart Failure Admission Rate16
10
Measure Votes
2827
24 24 24 24 2422
2120 20
19 19 19 1918 18
1716 16
0
5
10
15
20
25
30
Top 3: Monitored Controlling High Blood Pressure
Breast Cancer Screening
Adult Access to Preventive/Ambulatory Services
Pediatrics- Incentivized
Developmental Screening - First Three Years of Life 29
Well-Child Visits - First 15 Months of Life 29
Well-Child Visits - Third, Fourth, Fifth and Sixth Years of
Life25
Childhood Immunization Status 22
Adolescent Well-Care Visits 20
Weight Assessment and Counseling for Nutrition and
Physical Activity for Children/Adolescents – Body Mass
Index Assessment for Children/Adolescents
18
Immunizations for Adolescents 16
Percentage of Eligibles Who Received Preventive
Dental Services 16
Appropriate Treatment for Children With Upper
Respiratory Infection15
Lead Screening in Children 13
11
Measures Votes
29 29
25
2220
1816 16
1513
0
5
10
15
20
25
30
35
Top 3: Incentivized Developmental Screening in the First Three Years of Life
Well-Child Visits in the First 15 Months of Life
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years
of Life
Pediatrics- Monitored
Immunizations for Adolescents 30
Weight Assessment and Counseling for Nutrition
and Physical Activity for Children/Adolescents –
Body Mass Index Assessment for
Children/Adolescents
30
Adolescent Well-Care Visits 29
Childhood Immunization Status 29
Percentage of Eligibles Who Received Preventive
Dental Services 28
Appropriate Treatment for Children With Upper
Respiratory Infection26
Well-Child Visits in the Third, Fourth, Fifth and
Sixth Years of Life25
Well-Child Visits in the First 15 Months of Life 23
Lead Screening in Children 23
Developmental Screening in the First Three Years
of Life 22
12
Measures Votes
30 30 29 29 2826 25
23 23 22
0
5
10
15
20
25
30
35
Top 3: Monitored Immunizations for Adolescents
Weight Assessment and Counseling for Nutrition and Physical
Activity for Children/Adolescents – Body Mass Index
Assessment for Children/Adolescents
Adolescent Well-Care Visits
OB/MFM- Incentivized
Prenatal and Postpartum Care: Postpartum Care 24
Prenatal and Postpartum Care: Timeliness of Prenatal
Care 21
Contraceptive Care – All Women Ages 21–44 21
Initiation of Injectable Progesterone for Preterm Birth
Prevention16
Cesarean Rate for Low-Risk First Birth Women 15
Syphilis Screening During Pregnancy – 3rd Trimester 13
Contraceptive Care – Postpartum Women Ages 21–
4412
Non-recommended Cervical Cancer Screening in
Adolescent Females9
Elective Delivery or Early Induction Without Medical
Indication8
Percentage of Low Birthweight Births 8
Appropriate Use of Antenatal Steroids 5
Unexpected Complications in Term Newborns 4
13
24
21 21
1615
1312
98 8
54
0
5
10
15
20
25
30
Top 3: Incentivized Prenatal and Postpartum Care: Postpartum Care
Prenatal and Postpartum Care: Timeliness of Prenatal Care
Contraceptive Care – All Women Ages 21–44
Measures Votes
OB/MFM- Monitored
Syphilis Screening During Pregnancy – 3rd Trimester 26
Cesarean Rate for Low-Risk First Birth Women 26
Percentage of Low Birthweight Births 26
Elective Delivery or Early Induction Without Medical
Indication24
Unexpected Complications in Term Newborns 24
Prenatal and Postpartum Care: Timeliness of
Prenatal Care 23
Initiation of Injectable Progesterone for Preterm Birth
Prevention21
Appropriate Use of Antenatal Steroids 21
Prenatal and Postpartum Care: Postpartum Care 19
Non-recommended Cervical Cancer Screening in
Adolescent Females19
Contraceptive Care – Postpartum Women Ages 21–
4417
Contraceptive Care – All Women Ages 21–44 16
14
Measures Votes
26 26 2624 24
2321 21
19 1917
16
0
5
10
15
20
25
30
Top 3: Monitored Syphilis Screening During Pregnancy – 3rd Trimester
Cesarean Rate for Low-Risk First Birth Women
Percentage of Low Birthweight Births
Behavioral Health- Incentivized
Follow-Up After Hospitalization for Mental Illness 42
Depression Screening and Follow-Up for Adolescents
and Adults35
Follow-Up Care for Children Prescribed Attention-
Deficit/Hyperactivity Disorder Medication29
Initiation and Engagement of Alcohol and Other Drug
Abuse or Dependence Treatment 23
Antidepressant Medication Management 19
Diabetes Screening for People with Schizophrenia or
Bipolar Disorder Who Are Using Antipsychotic
Medications 17
Use of First-Line Psychosocial Care for Children and
Adolescents on Antipsychotics16
Depression Remission or Response for Adolescents
and Adults 14
Adherence to Antipsychotic Medications for Individuals
with Schizophrenia 14
Concurrent Use of Opioids and Benzodiazepines 14
15
Measures Votes
42
35
29
2319
17 1614 14 14
0
5
10
15
20
25
30
35
40
45
Top 3: Incentivized Follow-Up After Hospitalization for Mental Illness
Depression Screening and Follow-Up for Adolescents and
Adults
Follow-Up Care for Children Prescribed Attention-
Deficit/Hyperactivity Disorder Medication
Behavioral Health- Monitored
Concurrent Use of Opioids and Benzodiazepines 33
Use of First-Line Psychosocial Care for Children and
Adolescents on Antipsychotics29
Depression Remission or Response for Adolescents
and Adults 27
Follow-Up Care for Children Prescribed Attention-
Deficit/Hyperactivity Disorder Medication25
Depression Screening and Follow-Up for Adolescents
and Adults24
Initiation and Engagement of Alcohol and Other Drug
Abuse or Dependence Treatment 24
Adherence to Antipsychotic Medications for Individuals
with Schizophrenia 24
Antidepressant Medication Management 24
Follow-Up After Hospitalization for Mental Illness 22
Diabetes Screening for People with Schizophrenia or
Bipolar Disorder Who Are Using Antipsychotic
Medications
17
16
Measures Votes
33
2927
25 24 24 24 2422
17
0
5
10
15
20
25
30
35
Top 3: Monitored Concurrent Use of Opioids and Benzodiazepines
Use of First-Line Psychosocial Care for Children and
Adolescents on Antipsychotics
Depression Remission or Response for Adolescents and
Adults
ED-Incentivized
Follow-Up After Emergency Department Visit for
Alcohol and Other Drug Abuse or Dependence26
Potentially Preventable ED Visits 21
Ambulatory Care: Emergency Department Visits 14
17
Measures Votes
26
21
14
0
5
10
15
20
25
30
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse orDependencePotentially Preventable ED Visits
Ambulatory Care: Emergency Department Visits
Top 3: Incentivized Follow-Up After Emergency Department Visit for
Alcohol and Other Drug Abuse or Dependence
Potentially Preventable ED Visits
Ambulatory Care: Emergency Department Visits
ED-Monitored
Ambulatory Care: Emergency Department
Visits30
Potentially Preventable ED Visits 26
Follow-Up After Emergency Department
Visit for Alcohol and Other Drug Abuse or
Dependence
19
18
Measures Votes
0
5
10
15
20
25
30
35
Ambulatory Care: Emergency Department Visits
Potentially Preventable ED Visits
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence
Top 3: Monitored Ambulatory Care: Emergency Department Visits
Potentially Preventable ED Visits
Follow-Up After Emergency Department Visit for Alcohol
and Other Drug Abuse or Dependence
Care Process-Incentivized
Percentage of members who complete the initial
health needs assessment within 90 calendar days of
the enrollee’s effective date of enrollment
27
Potentially Preventable Readmissions 20
Percentage of provider payments linked to a value-
based payment model account in the measurement
year
13
Consumer Assessment of Healthcare Providers and
Systems (CAHPS®) Health Plan Survey 5.0H – Child
Version (Medicaid)
12
Consumer Assessment of Healthcare Providers and
Systems (CAHPS®) Health Plan Survey 5.0H, Adult
Version (Medicaid)
8
Plan All-Cause Readmissions 7
19
Measures Votes
27
20
13 12
8 7
0
5
10
15
20
25
30
Percentage of members who
complete the initial health needs
assessment within 90 calendar days of the enrollee’s effective date of
enrollment
PotentiallyPreventable
Readmissions
Percentage ofprovider paymentslinked to a value-based payment
model account inthe measurement
year
Consumer Assessment of
Healthcare Providers and
Systems (CAHPS®) Health
Plan Survey 5.0H –Child Version
(Medicaid)
ConsumerAssessment of
HealthcareProviders and
Systems(CAHPS®) HealthPlan Survey 5.0H,
Adult Version(Medicaid)
Plan All-CauseReadmissions
Top 3: Incentivized Percentage of members who complete the initial health needs
assessment within 90 calendar days of the enrollee’s effective
date of enrollment
Potentially Preventable Readmissions
Percentage of provider payments linked to a value-based
payment model account in the measurement year
Care Process-Monitored
Consumer Assessment of Healthcare
Providers and Systems (CAHPS®) Health
Plan Survey 5.0H – Child Version (Medicaid)
27
Consumer Assessment of Healthcare
Providers and Systems (CAHPS®) Health
Plan Survey 5.0H, Adult Version (Medicaid)
26
Percentage of members who complete the
initial health needs assessment within 90
calendar days of the enrollee’s effective date
of enrollment
22
Potentially Preventable Readmissions 21
Plan All-Cause Readmissions 18
Percentage of provider payments linked to a
value-based payment model account in the
measurement year
18
20
Measures Votes
2726
2221
18 18
0
5
10
15
20
25
30
Consumer Assessment of
Healthcare Providers and
Systems (CAHPS®) Health Plan Survey
5.0H – Child Version (Medicaid)
ConsumerAssessment of
HealthcareProviders and
Systems (CAHPS®)Health Plan Survey5.0H, Adult Version
(Medicaid)
Percentage of members who
complete the initial health needs
assessment within 90 calendar days of
the enrollee’s effective date of
enrollment
PotentiallyPreventable
Readmissions
Plan All-CauseReadmissions
Percentage ofprovider paymentslinked to a value-based payment
model account inthe measurement
year
Top 3: Monitored
Consumer Assessment of Healthcare Providers and
Systems (CAHPS®) Health Plan Survey 5.0H – Child
Version (Medicaid)
Consumer Assessment of Healthcare Providers and
Systems (CAHPS®) Health Plan Survey 5.0H, Adult
Version (Medicaid)
Percentage of members who complete the initial health
needs assessment within 90 calendar days of the
enrollee’s effective date of enrollment
Overall Ranking of All Incentivized Measures
21
Measures- Incentivized Votes
Follow-Up After Hospitalization for Mental Illness 42
Depression Screening and Follow-Up for Adolescents and Adults 35
Well-Child Visits in the First 15 Months of Life 29
Developmental Screening in the First Three Years of Life 29
Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder
Medication 29
Percentage of members who complete the initial health needs assessment within
90 calendar days of the enrollee’s effective date of enrollment 27
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or
Dependence 26
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life 25
Prenatal and Postpartum Care: Postpartum Care 24
Controlling High Blood Pressure 23
Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence
Treatment 23
Childhood Immunization Status 22
Prenatal and Postpartum Care: Timeliness of Prenatal Care 21
Contraceptive Care – All Women Ages 21–44 21
Potentially Preventable ED Visits 21
Adolescent Well-Care Visits 20
Potentially Preventable Readmissions 20
Antidepressant Medication Management 19
Adult Access to Preventive/Ambulatory Services 18
Weight Assessment and Counseling for Nutrition and Physical Activity for
Children/Adolescents – Body Mass Index Assessment for Children/Adolescents 18
Cervical Cancer Screening 17
HIV Screening 17
Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are
Using Antipsychotic Medications 17
Breast Cancer Screening 16
Percentage of Eligibles Who Received Preventive Dental Services 16
Immunizations for Adolescents 16
Measures- Incentivized Votes
Initiation of Injectable Progesterone for Preterm Birth Prevention 16
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics 16
Comprehensive Diabetes Care 15
Appropriate Treatment for Children With Upper Respiratory Infection 15
Cesarean Rate for Low-Risk First Birth Women 15
Depression Remission or Response for Adolescents and Adults 14
Adherence to Antipsychotic Medications for Individuals with Schizophrenia 14
Concurrent Use of Opioids and Benzodiazepines 14
Ambulatory Care: Emergency Department Visits 14
Lead Screening in Children 13
Syphilis Screening During Pregnancy – 3rd Trimester 13
Percentage of provider payments linked to a value-based payment model account in the
measurement year 13
Flu Vaccinations for Adults Ages 18 to 64 12
Colorectal Cancer Screening 12
Contraceptive Care – Postpartum Women Ages 21–44 12
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Health Plan Survey
5.0H – Child Version (Medicaid) 12
Medical Assistance With Smoking and Tobacco Use Cessation 11
HIV Viral Load Suppression 11
Chlamydia Screening in Women-Total 10
Adult Body Mass Index Assessment 9
Non-recommended Cervical Cancer Screening in Adolescent Females 9
HCV Screening 8
Elective Delivery or Early Induction Without Medical Indication 8
Percentage of Low Birthweight Births 8
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Health Plan Survey
5.0H, Adult Version (Medicaid) 8
Diabetes Short-Term Complications Admission Rate 7
Plan All-Cause Readmissions 7
Heart Failure Admission Rate 6
Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis 5
Appropriate Use of Antenatal Steroids 5
Statin Therapy for Patients with Cardiovascular Disease 4
Use of Imaging Studies for Low Back Pain 4
Unexpected Complications in Term Newborns 4
Asthma in Younger Adults Admission Rate 2
Chronic Obstructive Pulmonary Disease or Asthma in Older Adults Admission Rate 2
Overall Ranking of All Incentivized Measures
42
35
29 29 29
2726
2524
23 2322
21 21 2120 20
1918 18
17 17 1716 16 16 16 16
15 15 1514 14 14 14
13 13 1312 12 12 12
11 1110
9 98 8 8 8
7 76
5 54 4 4
2 2
0
5
10
15
20
25
30
35
40
45
Follo
w-U
p A
fte
r H
osp
ital
izat
ion
fo
r M
enta
l Illn
ess
Dep
ress
ion
Scr
een
ing
and
Fo
llow
-Up
fo
r A
do
lesc
ents
an
d…
Wel
l-C
hild
Vis
its
in t
he
Fir
st 1
5 M
on
ths
of
Life
Dev
elo
pm
enta
l Scr
een
ing
in t
he
Firs
t Th
ree
Year
s o
f Li
fe
Follo
w-U
p C
are
for
Ch
ildre
n P
resc
rib
ed
Att
enti
on
-…
Per
cen
tage
of
mem
ber
s w
ho
co
mp
lete
th
e in
itia
l hea
lth
…
Follo
w-U
p A
fte
r Em
erg
en
cy D
epar
tmen
t V
isit
fo
r A
lco
ho
l…
Wel
l-C
hild
Vis
its
in t
he
Th
ird
, Fo
urt
h, F
ifth
an
d S
ixth
Yea
rs…
Pre
nat
al a
nd
Po
stp
artu
m C
are
: Po
stp
artu
m C
are
Co
ntr
olli
ng
Hig
h B
loo
d P
ress
ure
Init
iati
on
an
d E
nga
gem
ent
of
Alc
oh
ol a
nd
Oth
er D
rug
Ab
use
…
Ch
ildh
oo
d Im
mu
niz
atio
n S
tatu
s
Pre
nat
al a
nd
Po
stp
artu
m C
are
: Tim
elin
ess
of
Pre
nat
al C
are
Co
ntr
acep
tive
Car
e –
All
Wo
men
Age
s 2
1–4
4
Po
ten
tial
ly P
reve
nta
ble
ED
Vis
its
Ad
ole
scen
t W
ell-
Car
e V
isit
s
Po
ten
tial
ly P
reve
nta
ble
Re
adm
issi
on
s
An
tid
epre
ssan
t M
edic
atio
n M
anag
emen
t
Ad
ult
Acc
ess
to
Pre
ven
tive
/Am
bu
lato
ry S
ervi
ces
Wei
ght
Ass
essm
ent
and
Co
un
selin
g fo
r N
utr
itio
n a
nd
…
Cer
vica
l Can
cer
Scre
enin
g
HIV
Scr
een
ing
Dia
bet
es S
cree
nin
g fo
r P
eo
ple
wit
h S
chiz
op
hre
nia
or…
Bre
ast
Can
cer
Scre
enin
g
Per
cen
tage
of
Elig
ible
s W
ho
Rec
eive
d P
reve
nti
ve D
enta
l…
Imm
un
izat
ion
s fo
r A
do
lesc
en
ts
Init
iati
on
of
Inje
ctab
le P
roge
ste
ron
e fo
r P
rete
rm B
irth
…
Use
of
Firs
t-Li
ne
Psy
cho
soci
al C
are
for
Ch
ildre
n a
nd
…
Co
mp
reh
ensi
ve D
iab
ete
s C
are
Ap
pro
pri
ate
Trea
tmen
t fo
r C
hild
ren
Wit
h U
pp
er…
Ces
area
n R
ate
for
Low
-Ris
k Fi
rst
Bir
th W
om
en
Dep
ress
ion
Rem
issi
on
or
Res
po
nse
fo
r A
do
lesc
ents
an
d…
Ad
he
ren
ce t
o A
nti
psy
cho
tic
Med
icat
ion
s fo
r In
div
idu
als…
Co
ncu
rre
nt
Use
of
Op
ioid
s an
d B
enzo
dia
zep
ines
Am
bu
lato
ry C
are:
Em
erge
ncy
De
par
tme
nt
Vis
its
Lead
Scr
een
ing
in C
hild
ren
Syp
hili
s Sc
reen
ing
Du
rin
g P
regn
ancy
–3
rd T
rim
este
r
Per
cen
tage
of
pro
vid
er
pay
men
ts li
nke
d t
o a
val
ue-
bas
ed…
Flu
Vac
cin
atio
ns
for
Ad
ult
s A
ges
18
to
64
Co
lore
ctal
Can
cer
Scre
enin
g
Co
ntr
acep
tive
Car
e –
Po
stp
artu
m W
om
en A
ges
21
–44
Co
nsu
mer
Ass
essm
ent
of
Hea
lth
care
Pro
vid
ers
and
Sys
tem
s …
Med
ical
Ass
ista
nce
Wit
h S
mo
kin
g an
d T
ob
acco
Use
Ces
sati
on
HIV
Vir
al L
oad
Su
pp
ress
ion
Ch
lam
ydia
Scr
een
ing
in W
om
en-T
ota
l
Ad
ult
Bo
dy
Mas
s In
dex
Ass
essm
en
t
No
n-r
eco
mm
end
ed C
ervi
cal C
ance
r Sc
ree
nin
g in
…
HC
V S
cree
nin
g
Elec
tive
Del
iver
y o
r Ea
rly
Ind
uct
ion
Wit
ho
ut
Med
ical
…
Per
cen
tage
of
Low
Bir
thw
eigh
t B
irth
s
Co
nsu
mer
Ass
ess
men
t o
f H
ealt
hca
re P
rovi
der
s an
d S
yste
ms…
Dia
bet
es S
ho
rt-T
erm
Co
mp
licat
ion
s A
dm
issi
on
Rat
e
Pla
n A
ll-C
ause
Rea
dm
issi
on
s
Hea
rt F
ailu
re A
dm
issi
on
Rat
e
Avo
idan
ce o
f A
nti
bio
tic
Tre
atm
ent
in A
du
lts
Wit
h A
cute
…
Ap
pro
pri
ate
Use
of
An
ten
atal
Ste
roid
s
Stat
in T
he
rap
y fo
r P
atie
nts
wit
h C
ard
iova
scu
lar
Dis
eas
e
Use
of
Imag
ing
Stu
die
s fo
r Lo
w B
ack
Pai
n
Un
exp
ecte
d C
om
plic
atio
ns
in T
erm
New
bo
rns
Ast
hm
a in
Yo
un
ger
Ad
ult
s A
dm
issi
on
Rat
e
Ch
ron
ic O
bst
ruct
ive
Pu
lmo
nar
y D
isea
se o
r A
sth
ma
in O
lde
r…
22
Overall Ranking of All Monitored MeasuresMeasure- Monitored Votes
Concurrent Use of Opioids and Benzodiazepines 33
Immunizations for Adolescents 30
Weight Assessment and Counseling for Nutrition and Physical Activity for
Children/Adolescents – Body Mass Index Assessment for Children/Adolescents30
Ambulatory Care: Emergency Department Visits 30
Adolescent Well-Care Visits 29
Childhood Immunization Status 29
Use of First-Line Psychosocial Care for Children and Adolescents on
Antipsychotics29
Controlling High Blood Pressure 28
Percentage of Eligibles Who Received Preventive Dental Services 28
Breast Cancer Screening 27
Depression Remission or Response for Adolescents and Adults 27
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Health
Plan Survey 5.0H – Child Version (Medicaid)27
Appropriate Treatment for Children With Upper Respiratory Infection 26
Syphilis Screening During Pregnancy – 3rd Trimester 26
Cesarean Rate for Low-Risk First Birth Women 26
Percentage of Low Birthweight Births 26
Potentially Preventable ED Visits 26
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Health
Plan Survey 5.0H, Adult Version (Medicaid)26
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life 25
Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder
Medication25
Adult Access to Preventive/Ambulatory Services 24
Flu Vaccinations for Adults Ages 18 to 64 24
Adult Body Mass Index Assessment 24
Medical Assistance With Smoking and Tobacco Use Cessation 24
Comprehensive Diabetes Care 24
Elective Delivery or Early Induction Without Medical Indication 24
Unexpected Complications in Term Newborns 24
Depression Screening and Follow-Up for Adolescents and Adults 24
Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence
Treatment 24
Adherence to Antipsychotic Medications for Individuals with Schizophrenia 24
23
Measure- Monitored Votes
Antidepressant Medication Management 24
Well-Child Visits in the First 15 Months of Life 23
Lead Screening in Children 23
Prenatal and Postpartum Care: Timeliness of Prenatal Care 23
Colorectal Cancer Screening 22
Developmental Screening in the First Three Years of Life 22
Follow-Up After Hospitalization for Mental Illness 22
Percentage of members who complete the initial health needs assessment within
90 calendar days of the enrollee’s effective date of enrollment22
Asthma in Younger Adults Admission Rate 21
Initiation of Injectable Progesterone for Preterm Birth Prevention 21
Appropriate Use of Antenatal Steroids 21
Potentially Preventable Readmissions 21
HIV Screening 20
HCV Screening 20
Cervical Cancer Screening 19
Statin Therapy for Patients with Cardiovascular Disease 19
Chronic Obstructive Pulmonary Disease or Asthma in Older Adults Admission
Rate19
Use of Imaging Studies for Low Back Pain 19
Prenatal and Postpartum Care: Postpartum Care 19
Non-recommended Cervical Cancer Screening in Adolescent Females 19
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or
Dependence19
Chlamydia Screening in Women-Total 18
HIV Viral Load Suppression 18
Plan All-Cause Readmissions 18
Percentage of provider payments linked to a value-based payment model account
in the measurement year18
Diabetes Short-Term Complications Admission Rate 17
Contraceptive Care – Postpartum Women Ages 21–44 17
Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are
Using Antipsychotic Medications 17
Heart Failure Admission Rate 16
Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis 16
Contraceptive Care – All Women Ages 21–44 16
Overall Ranking of All Monitored Measures
33
30 30 3029 29 29
28 2827 27 27
26 26 26 26 26 2625 25
24 24 24 24 24 24 24 24 24 24 2423 23 23
22 22 22 2221 21 21 21
20 2019 19 19 19 19 19 19
18 18 18 1817 17 17
16 16 16
0
5
10
15
20
25
30
35C
on
curr
en
t U
se o
f O
pio
ids
and
Ben
zod
iaze
pin
es
Imm
un
izat
ion
s fo
r A
do
lesc
en
ts
Wei
ght
Ass
essm
ent
and
Co
un
selin
g fo
r N
utr
itio
n a
nd
Ph
ysic
al …
Am
bu
lato
ry C
are:
Em
erge
ncy
De
par
tme
nt
Vis
its
Ad
ole
scen
t W
ell-
Car
e V
isit
s
Ch
ildh
oo
d Im
mu
niz
atio
n S
tatu
s
Use
of
Firs
t-Li
ne
Psy
cho
soci
al C
are
for
Ch
ildre
n a
nd
…
Co
ntr
olli
ng
Hig
h B
loo
d P
ress
ure
Per
cen
tage
of
Elig
ible
s W
ho
Rec
eive
d P
reve
nti
ve D
enta
l…
Bre
ast
Can
cer
Scre
enin
g
Dep
ress
ion
Rem
issi
on
or
Res
po
nse
fo
r A
do
lesc
ents
an
d A
du
lts
Co
nsu
mer
Ass
essm
ent
of
Hea
lth
care
Pro
vid
ers
and
Sys
tem
s …
Ap
pro
pri
ate
Trea
tmen
t fo
r C
hild
ren
Wit
h U
pp
er R
esp
irat
ory
…
Syp
hili
s Sc
reen
ing
Du
rin
g P
regn
ancy
–3
rd T
rim
este
r
Ces
area
n R
ate
for
Low
-Ris
k Fi
rst
Bir
th W
om
en
Per
cen
tage
of
Low
Bir
thw
eigh
t B
irth
s
Po
ten
tial
ly P
reve
nta
ble
ED
Vis
its
Co
nsu
mer
Ass
ess
men
t o
f H
ealt
hca
re P
rovi
der
s an
d S
yste
ms…
Wel
l-C
hild
Vis
its
in t
he
Th
ird
, Fo
urt
h, F
ifth
an
d S
ixth
Yea
rs o
f Li
fe
Follo
w-U
p C
are
for
Ch
ildre
n P
resc
rib
ed
Att
enti
on
-…
Ad
ult
Acc
ess
to
Pre
ven
tive
/Am
bu
lato
ry S
ervi
ces
Flu
Vac
cin
atio
ns
for
Ad
ult
s A
ges
18
to
64
Ad
ult
Bo
dy
Mas
s In
dex
Ass
essm
en
t
Med
ical
Ass
ista
nce
Wit
h S
mo
kin
g an
d T
ob
acco
Use
Ces
sati
on
Co
mp
reh
ensi
ve D
iab
ete
s C
are
Elec
tive
Del
iver
y o
r Ea
rly
Ind
uct
ion
Wit
ho
ut
Med
ical
Ind
icat
ion
Un
exp
ecte
d C
om
plic
atio
ns
in T
erm
New
bo
rns
Dep
ress
ion
Scr
een
ing
and
Fo
llow
-Up
fo
r A
do
lesc
ents
an
d A
du
lts
Init
iati
on
an
d E
nga
gem
ent
of
Alc
oh
ol a
nd
Oth
er D
rug
Ab
use
…
Ad
he
ren
ce t
o A
nti
psy
cho
tic
Med
icat
ion
s fo
r In
div
idu
als
wit
h…
An
tid
epre
ssan
t M
edic
atio
n M
anag
emen
t
Wel
l-C
hild
Vis
its
in t
he
Fir
st 1
5 M
on
ths
of
Life
Lead
Scr
een
ing
in C
hild
ren
Pre
nat
al a
nd
Po
stp
artu
m C
are
: Tim
elin
ess
of
Pre
nat
al C
are
Co
lore
ctal
Can
cer
Scre
enin
g
Dev
elo
pm
enta
l Scr
een
ing
in t
he
Firs
t Th
ree
Year
s o
f Li
fe
Follo
w-U
p A
fte
r H
osp
ital
izat
ion
fo
r M
enta
l Illn
ess
Per
cen
tage
of
mem
ber
s w
ho
co
mp
lete
th
e in
itia
l hea
lth
nee
ds …
Ast
hm
a in
Yo
un
ger
Ad
ult
s A
dm
issi
on
Rat
e
Init
iati
on
of
Inje
ctab
le P
roge
ste
ron
e fo
r P
rete
rm B
irth
…
Ap
pro
pri
ate
Use
of
An
ten
atal
Ste
roid
s
Po
ten
tial
ly P
reve
nta
ble
Re
adm
issi
on
s
HIV
Scr
een
ing
HC
V S
cree
nin
g
Cer
vica
l Can
cer
Scre
enin
g
Stat
in T
he
rap
y fo
r P
atie
nts
wit
h C
ard
iova
scu
lar
Dis
eas
e
Ch
ron
ic O
bst
ruct
ive
Pu
lmo
nar
y D
isea
se o
r A
sth
ma
in O
lde
r…
Use
of
Imag
ing
Stu
die
s fo
r Lo
w B
ack
Pai
n
Pre
nat
al a
nd
Po
stp
artu
m C
are
: Po
stp
artu
m C
are
No
n-r
eco
mm
end
ed C
ervi
cal C
ance
r Sc
ree
nin
g in
Ad
ole
scen
t…
Follo
w-U
p A
fte
r Em
erg
en
cy D
epar
tmen
t V
isit
fo
r A
lco
ho
l an
d…
Ch
lam
ydia
Scr
een
ing
in W
om
en-T
ota
l
HIV
Vir
al L
oad
Su
pp
ress
ion
Pla
n A
ll-C
ause
Rea
dm
issi
on
s
Per
cen
tage
of
pro
vid
er
pay
men
ts li
nke
d t
o a
val
ue-
bas
ed…
Dia
bet
es S
ho
rt-T
erm
Co
mp
licat
ion
s A
dm
issi
on
Rat
e
Co
ntr
acep
tive
Car
e –
Po
stp
artu
m W
om
en A
ges
21
–44
Dia
bet
es S
cree
nin
g fo
r P
eo
ple
wit
h S
chiz
op
hre
nia
or
Bip
ola
r…
Hea
rt F
ailu
re A
dm
issi
on
Rat
e
Avo
idan
ce o
f A
nti
bio
tic
Tre
atm
ent
in A
du
lts
Wit
h A
cute
…
Co
ntr
acep
tive
Car
e –
All
Wo
men
Age
s 2
1–4
4
24
25
26
Review of Proposed Quality Measures
Summary of Performance Measure Changes (Handout)
• Performance measures set increased from 51 to 64 measures
• Incentivized measures were reduced from 16 to 12
• 10 new incentivized measures
• 9 current incentivized measures moved to monitored
• 3 incentivized measures moved to managed care incentive payment program
• Measures voted to be incentivized that were retired from national endorsement were not incentivized (eg. Ambulatory visits-ED visits)
• Some monitored measures to be stratified by race/ethnicity
29
Review of Current Quality Measures
32
Review of Proposed Quality Measures
Quality Dashboard-Demo
Open Forum &
? Vote to Recommend
Questions or Feedback Contact
Marcus Bachhuber, MD, MS, FACP, Medicaid Chief Medical Officer
Email: [email protected]
Pooja Mehta, MD, MSHP, FACOG, Medicaid Chief Clinical Innovation Officer
Email: [email protected]
www.ldh.la.gov/medicaidquality
