The Department of Health and Human Services (HHS) has published its final set of 26 core quality measures for adult Medicaid beneficiaries that states, providers, and insurers can use on a voluntary basis to manage care delivery and improve quality, according to a recent posting in the Federal Register.

“Identification of the initial core set of measures for Medicaid-eligible adults is an important first step in an overall strategy to encourage and enhance quality improvement,” the HHS posting said.

“States that choose to collect the initial core set will be better positioned to measure their performance and develop action plans to achieve the three-part aims of better care, healthier people, and affordable care.”
Through an evaluation process, an original listing of more than 1,000 measures was narrowed down to 51 when a draft rule came out in December 2010. What remains are slightly more than two dozen measures set across six major categories.

The six are prevention and health promotion, management of acute conditions, management of chronic conditions, family experience of care, care coordination, and availability. Examples of measure names include annual HIV/AIDS medical visits, controlling high blood pressure, diabetes screenings, antidepressant medication management, and annual monitoring for patients on persistent medications. All of those measures come under the management of chronic conditions category.

The final rule for core measures is just part of a process spelled out in the health care reform law, HHS said. Over the next year, the Centers for Medicare & Medicaid Services (CMS) will phase in parts of the Medicaid Adult Quality Measures Program that will help to further identify measurement gap areas.