Risk & Quality Management Team: Quality Improvement Unit (QIU)

% of the total measures in the Medicaid Adult & Child Core Measure Sets reported to Centers for Medicaid & Medicare Services (CMS)

94.8%2022

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Notes on Methodology

 

Partners
  • DVHA Data Unit
  • Contractor to produce the performance measures
Story Behind the Curve

This measure is important because the CMS Core Sets of healthcare quality measures for adult and children are often used to provide a snapshot of quality within Medicaid. They are not comprehensive, but prior to their creation and implementation, performance measurement varied greatly by state, and it was not possible to glean an overall picture of quality. Statute requires CMS to release annual reports on behalf of the Secretary on the reporting of state-specific adult Medicaid quality information. 

One of the biggest challenges that DVHA faces related to performance measure production has to do with measures that require gathering clinical elements from medical records. We have learned from past years that we could improve our process for medical record collection from providers’ offices, as well as the process of preparing training materials for new measures.  As we move into 2021, the Quality Unit will be partnering with other units within DVHA to improve those aspects of our medical record review process. 

The trendline above demonstrates DVHA’s commitment to increasing our CMS Core Set measure production. Doing so is key to the state’s ability to keep pace with other state Medicaid plans and to evaluate the effectiveness of our payment reform models.  As we strive to report on all performance measures within the CMS core quality measure sets by 2024, the Quality Improvement team: 

  • Partners with the Data Unit to maintain an already high level of accurate and complete reporting
  • Fosters new partnerships with staff who work closely with the Vermont Clinical Registry so that we can think creatively about the best use of our resources moving forward
  • Actively engages in annual budgetary conversations related to performance measure set reporting

Narrative last updated:  12/03/2020

Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy