GenIC #26 FFY 2014 Medicaid Adult Quality Measures Template Crosswalk

	FFY 2013 (old version)	FFY 2014 (new version)	Type of Change (Rev, New)	Reason for Change	Burden Change
All changes to the template fall into 3 primary buckets: To align with the current measure steward technical specifications, to reflect annual updates to the Core Set as per Section 1139B of the Affordable Care Act, and/or to facilitate improvements in reporting by states through clarified information/instructions and result in improved analysis of data by CMS. These changes have been categorized into substantive and non-substantive changes:
Substantive Changes:
Throughout the document
	initial Core Set	Core Set	Rev	The Medicaid Adult Core Set now reflects the first set of annual updates to the Core Set as per Section 1139B of the Affordable Care Act, so it is no longer initial (one measure was retired, and another measure added in its place).	No
	Annual HIV/AIDS Medicaid Visit	HIV Viral Load Suppression	Rev	References to the Annual HIV/AIDS Medicaid Visit measure have been deleted as this measure was retired from the Core Set in January 2014. HIV Viral Load Suppression was added to the template, as this measure was added to the Core Set in January 2014. This change is reflected throughout the template, including in Table 1 and on the measure-specific pages.	No
Background
		The Affordable Care Act also required the Secretary to publish annual changes to the Medicaid Adult Core Set measures beginning in January 2014. One measure (Annual HIV/AIDS Medicaid Visit) was retired from the Medicaid Adult Core Set in 2014 and replaced with HIV Viral Load Suppression. Table 1 lists the Medicaid Adult Core Set measures, their measure stewards, and a general description of each measure. Measure abbreviations were added in 2014.	New	To provid information on the changes to the 2014 Core Set.	No
Table 1.
		Updates to the Measure Column	Rev	All changes to the measure names reflect changes specified by the measure steward for each measure. [these changes are also reflected on the measure-specific pages]	No
		Updates to the Measure Description Column	Rev	All changes to the measure description reflect changes specified by the measure steward for each measure. [these changes are also reflected on the measure-specific pages in the Performance Measure section]	No
Guidance for Reporting
		(Under the hybrid option of the 'Data Source' question) If this box is selected, the user must then indicate whether the administrative data for a measure are coming from the Medicaid Management Information System (MMIS) or another administrative data source. The user must also indicate whether the medical record data for a measure are coming from electronic health records (EHR), paper, or EHR and paper.	New	CMS has added two sub-questions to better understand the sources of both the administrative data and the medical records data that comprise this data source. These new sub-questions replace an open-ended text field so that data can be collected uniformly and analyzed in a more streamlined and consistent way. If state users select this option, they must then indicate whether the administrative data for the measure are coming from the Medicaid Management Information System (MMIS) or another administrative data source. The user must also indicate whether the medical records data for a measure are coming from electronic health records (EHR), paper, or EHR and paper. [this change is also reflected in the data source fields of the measure-specific template pages for all applicable measures]	No
		For the question, “Did you Combine Rates from Multiple Reporting Units (e.g., health plans, delivery systems, programs) to Create a State-Level Rate?, ” states should indicate whether state-level rates were calculated based on rates for multiple reporting units, and if so, whether the rates were weighted based on the size of the measure-eligible population or other factor or were not weighted.	New	Added instruction about a new question added to the template in which states are asked to indicate whether state-level rates were calculated based on rates for multiple reporting units, and if so, whether the rates were weighted based on the size of the measure-eligible population or other factor or were not weighted. This new question replaces a free-form text field to yield more standardized information from states for purposes of data analysis [this change is reflected as a new reporting field in measure-specific pages for all measures]	No
		Maternal and Infant Health Initiative Measures: To determine baseline and assess progress towards the CMS Maternal and Infant Health Initiative goals, states have the option to voluntarily report on 2 measures: 1. Postpartum Care Rate (Measure PPC-AD) from the Medicaid Adult Core Set; and 2. A developmental measure on Contraception Service Utilization. Postpartum Care Rate and the developmental contraceptive measure can be found as the last two measures in both the CARTS web-based template and this Word template. The technical specifications for the Postpartum Care measure are available in the Technical Specifications and Resource Manual. The technical specifications for the developmental measure are available at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/Maternal-and-Infant-Health-Care-Quality.html.	New	As the Medicaid Adult Quality Measures Template in CARTS will serve as the vehicle states will use to report data on two performance measures as part of the forthcoming Adult Medicaid Quality: Improving Maternal and Infant Health Outcomes in Medicaid and CHIP FOA, a new section about this effort was added to the Guidance for Reporting. This new section details the two measures that will be used to determine baselines and assess progress towards the Maternal and Infant Health Initiative goals (Postpartum Care Rate, which is already part of the Medicaid Adult Core Set, and a developmental measure on Contraception Service Utilization), and provides information about where in the CARTS system these measures can be located. [the section of the template containing the measures-specific pages has been modified to include the new developmental measure, and an additional question has been added to the Postpartum Care Rate measure to determine which states are reporting the measure voluntarily as part of the FOA]	No
Measure-Specific Pages
		Updates to the Measure Names	Rev	All changes to the measure names reflect changes to the name as specified by the measure steward for each measure. [these changes are also reflected on the measure-specific pages]	No
	(Under the ‘If Data Not Reported, Please Explain Why’ field) “Not identified as a key priority area for this year”	[removed]	Rev	This response option has been removed due to stakeholder feedback. This response option was also not widely used during the first year of the reporting the Medicaid Adult Core Set.	No
		Under Data Source, CMS has remove sources that are not applicable for each measure	Rev	This change was made so reporting would be more streamlined for states.	No
		(Under the hybrid option of the 'Data Source' question) From where is the Administrative Data coming? Must select one or more: 0 Medicaid Management Information System (MMIS) 0 Other. Specify: From where is the Medical Records Data coming? Must select one: 0 Electronic Health Record (EHR) Data 0 Paper 0 Both (EHR and paper)	New	CMS added two sub-questions under the hybrid option to better understand the sources of both the administrative data and the medical records data that comprise this data source.	Yes. Minor impact. While this option now includes two sub-questions, CMS also removed options from the data source column which are not applicable to measures, in order to streamline reporting for states. As a result, we expect either a net 0 impact or a minor increase in burden through the addition of these sub-questions.
		Updates to the Performance Measure field	Rev	All changes to the text under Performance Measure (for all measures) reflect changes to the description as specified by the measure steward for each measure.	No
		Did you Combine Rates from Multiple Reporting Units (e.g., health plans, delivery systems, programs) to Create a State-Level Rate? 0 Yes If yes, indicate whether the state-level rate is weighted: 0 The rates are weighted based on the size of the measure-eligible population for each reporting unit 0 The rates are weighted based on another weighting factor 0 The rates are not weighted 0 No	New	CMS added was added to the Performance Measure field, in which states are asked to indicate whether state-level rates were calculated based on rates for multiple reporting units, and if so, whether the rates were weighted based on the size of the measure-eligible population or other factor or were not weighted. This new question replaces a free-form text field to yield more standardized information from states for purposes of data analysis.	Yes. Minor impact. This is a new question in the template, but as it's a Y/N question, we do not expect that it should not substantially increase the time it takes states to report each measure.
	Annual HIV/AIDS Medicaid Visit	HIV Viral Load Suppression	Rev	The Annual HIV/AIDS Medicaid Visit measure was deleted as this measure was retired from the Core Set in January 2014. The HIV Viral Load Suppression measure was added as this measure was added to the Core Set in January 2014. These updates are per Section 1139B of the Affordable Care Act.	No.
		(Postpartum Care Measure) The information for this measure is being provided as part of the Improving Maternal and Infant Health Outcomes in Medicaid and CHIP Reporting Incentive Grant 0 Yes 0 No	New	As per the edit to the ‘Guidance for Reporting’ section, an additional question has been added to the Postpartum Care Rate measure, The information for this measure is being provided as part of the Improving Maternal and Infant Health Outcomes in Medicaid and CHIP Reporting Incentive Grant,” to help assess which states are reporting the measure voluntarily as part of the Adult Medicaid Quality: Improving Maternal and Infant Health Outcomes in Medicaid and CHIP FOA.	Yes. Minor impact. This is a new question in the template, but as it's only a Y/N question to understand who may be voluntarily reporting it as part of the Adult Medicaid Quality: Improving Maternal and Infant Health Outcomes in Medicaid and CHIP FOA, we do not expect that it should not substantially increase the time it takes states to report the measure.
		Maternal and Infant Health Initiative Developmental Measure: Contraceptive Effectiveness measure	New	As per the edit to the ‘Guidance for Reporting’ section, a measure page to capture reporting on the developmental measure on contraceptive effectiveness as part of the Adult Medicaid Quality: Improving Maternal and Infant Health Outcomes in Medicaid and CHIP FOA has been added to the template.	Yes. While a new measure has been added to the template, it is only voluntarily reported by those states who are reporting as part of the Adult Medicaid Quality: Improving Maternal and Infant Health Outcomes in Medicaid and CHIP FOA. States not choosing to report the measure need only respond to the first question for this measure in order to proceed.
Non-Substantive Changes
Table 1.		Measure Abbreviations Column	New	Table amended to add measure abbreviations for each measure, so measures can be referenced shorthand and because the measure numbers may change each year with annual updates to the core set. [this change is also reflected on the measure-specific pages]	No
Guidance for Reporting
	‘Current year’	"performance period specified in the technical specifications"	Rev	Changed for accuracy	No
	"requirements” of the Adult Medicaid Quality Measures Grant Program	“as part of” the Adult Medicaid Quality Measures Grant Program	Rev	Since the grant program ends before FFY 14 reporting, grantees are not required to submit data on the measures in the coming year, so this language has been modified for accuracy.	No
	adheres to the technical specifications	adheres to the "Medicaid Adult Core Set" technical specifications	Rev	Edited to that it is clear the Medicaid Adult Core Set specifications are being referenced in this section.	No
	HEDIS Version 2013	HEDIS Version 2014	Rev	Revised to reflect the current HEDIS version	No
	Administrative Data: Medical claims and encounter data.	Administrative Data: Medical claims and encounter data or other administrative data source (e.g. immunization registry, vital records).	Rev	Provided additional examples of other types of administrative data that are included under this selection, including immunization registry and vital records, to provide greater clarity to state users.	No
	(Under Date Range) ‘please report’	define’	Rev	Revision made for clarity	No
	Indicate the definition of the population included in the denominator for each measure by checking one box to indicate whether the data are for the Medicaid population only (Title XIX), the CHIP population only (e.g., pregnant women; Title XXI), the Medicare and Medicaid dually-eligible populations, or another population using the “Other” check box.	Indicate the definition of the population included in the denominator for each measure by checking all boxes that apply to indicate whether the data are for the Medicaid population (Title XIX), the CHIP population (e.g., pregnant women; Title XXI), the Medicare and Medicaid dually-eligible populations, or another population using the “Other” check box.	Rev	Inserted "all boxes that apply" and deleted references to "only" to align with the reporting fields in the measure-specific template pages to clarify that state users may select as many boxes as applicable under this reporting field.	No
	(Under Does this Denominator Represent you Total Eligible Population as Defined by the Technical Specification for this Measure) States should indicate whether the denominator selected in the preceding question represents your state’s total eligible population for the measure, as defined by the Technical Specifications by selecting either Yes or No.	States should indicate whether the denominator selected in the preceding question represents your state’s total eligible population for the measure, as defined by the Technical Specifications for the measure by selecting either Yes or No.	Rev	Inserted 'for the measure' to clarify that this information is requested specific to each measure.	No
	(Under Which Delivery Systems are Represented in the Denominator) For each measure, the state is asked to indicate which delivery systems are represented in the denominator, the percentage of the total state population is represented in the measure for each delivery system, and the number of health plans represented in the measure for each delivery system (where applicable) across the following options: • Fee-for-Service • Primary Care Case Management (PCCM) • Managed Care Organization/Prepaid Inpatient Health Plan (MCO/PIHP) • Integrated Care Models (ICM) • Other	For each measure, the state is asked to indicate which delivery systems are represented in the denominator, the percentage of the total state population is represented in the measure for each delivery system, and the number of health plans represented in the measure for each delivery system (where applicable) across the following options: • Fee-for-Service • Primary Care Case Management (PCCM) • Managed Care Organization/Prepaid Inpatient Health Plan (MCO/PIHP) • Integrated Care Models (ICM) • Other Examples: 1. If the measure-eligible population represents all managed care enrollees, enter 100 percent. 2. If fee-for-service enrollees are excluded from the calculation, enter 0 percent. 3. If a portion of the health plans are excluded, enter the proportion of the population represented by the reporting health plans (e.g., 60 percent).	Rev	Change made to better specify that this information is requested specific to each measure. CMS also provided examples to clarify that we are seeking information about percentage of the total state population represented in the measure for each delivery system, and the number of health plans represented in the measure for each delivery system through this question. CMS’ review of the data from first year reporting showed that states interpreted this question differently, so it is our expectation that this information better clarifies the information requested in order to yield more consistent, standardized information from states. [these changes are also reflected on the measure-specific pages for all measures]	No
	(Under Performance Measure) Report the numerators, and denominators, rates for each measure (or component) in this section. The template provides two sections for entering the data, depending on whether you are reporting using the technical specifications provided by the measure steward for each measure or another methodology. The form fields have been set up to facilitate entering numerators and denominators for each measure. If the form fields do not give you enough space to fully report on the measure, please use the “additional notes” section. “Additional Notes/Comments on Measure” may be entered but is not required. Please note that some measures require reporting of multiple rates.	Report the numerators, denominators, and rates for each measure (or component) in this section. The template provides two sections for entering the data, depending on whether you are reporting using the technical specifications provided by the measure steward for each measure or another methodology. The form fields have been set up to facilitate entering numerators and denominators for each measure. If the form fields do not give you enough space to fully report on the measure, please use the “additional notes” section. “Additional Notes/Comments on Measure” may be entered but is not required. Please note that some measures require reporting of multiple rates.	Rev	Added a sentence to the end of the section to specify that some measures require the reporting of multiple rates. Also made some minor text corrections in the paragraph.	No
	(Under Optional Measure Stratification) If there are other or additional racial, ethnic, sex, language, disability status, or geographic stratifications your state wants to report that are not specified in the form provided, please upload the numerator(s), denominator(s), and rate(s), along with a brief description of the stratification, to the attachment facility.	If there are other or additional racial, ethnic, sex, language, disability status, or geographic stratifications your state wants to report that are not specified in the form provided, or if stratified data for measures with multiple rates are being provided, please upload the numerator(s), denominator(s), and rate(s), along with a brief description of the stratification, to the attachment facility.	Rev	Inserted a sentence to provide an additional example of the type of information that states should upload to the CARTS attachment facility for this section of the template. Some states were confused about how to report stratified data for measures that require the reporting of multiple rates, so an example was provided to clarify that this information should be uploaded to the attachment facility. [this change is also reflected on the measure-specific pages for all measures]	No
Measure-Specific Pages
	measure numbers	abbreviations	Rev	Measure abbreviations replace measures numbers so measures can be referenced shorthand and because the measure numbers may change each year with annual updates to the core set.	No
	FFY 2013	FFY 2014	Rev	Updated the fiscal year for which the template applies.	No
	"requirements” of the Adult Medicaid Quality Measures Grant Program	“as part of” the Adult Medicaid Quality Measures Grant Program	Rev	Since the grant program ends before FFY 14 reporting, grantees are not required to submit data on the measures in the coming year, so this language has been modified for accuracy.	No
	Which delivery systems are represented in the denominator? Select all that apply (Must select at least one): 0 Fee-for-Service Percentage of population represented: 0 Primary Care Case Management (PCCM) Percentage of population represented: 0 Managed Care Organization/Prepaid Inpatient Health Plan (MCO/PIHP) Number of health plans: Percentage of population represented: 0 Integrated Care Models (ICM) Percentage of population represented: 0 Other Describe: Percentage of population represented: If applicable, number of health plans represented:	Which delivery systems are represented in the denominator? Select all delivery systems that apply in your state (Must select at least one); for each delivery system, enter the percentage of the total state population represented in the measure. For example, if the measure-eligible population represents all managed care enrollees, enter 100 percent.: 0 Fee-for-Service Percentage of total state FFS population represented: 0 Primary Care Case Management (PCCM) Percentage of total state PCCM population represented: 0 Managed Care Organization/Prepaid Inpatient Health Plan (MCO/PIHP) Number of health plans: Percentage of total state MCO/PIHP population represented: 0 Integrated Care Models (ICM) Percentage of total state ICM population represented: 0 Other Describe: Percentage of total other population represented: If applicable, number of health plans represented:	Rev	As per the edit to the guidance for reporting, change made to better specify that this information is requested specific to each measure. CMS also provided examples to clarify that we are seeking information about percentage of the total state population represented in the measure for each delivery system, and the number of health plans represented in the measure for each delivery system through this question. CMS’ review of the data from first year reporting showed that states interpreted this question differently, so it is our expectation that this information better clarifies the information requested in order to yield more consistent, standardized information from states.	No
	(Under Optional Measure Stratification) If there are other or additional racial, ethnic, sex, language, disability status, or geographic stratifications your state wants to report that are not specified in the form provided, please upload the numerator(s), denominator(s), and rate(s), along with a brief description of the stratification, to the attachment facility.	If there are other or additional racial, ethnic, sex, language, disability status, or geographic stratifications your state wants to report that are not specified in the form provided, or if stratified data for measures with multiple rates are being provided, please upload the numerator(s), denominator(s), and rate(s), along with a brief description of the stratification, to the attachment facility.	Rev	Inserted a sentence to provide an additional example of the type of information that states should upload to the CARTS attachment facility for this section of the template. Some states were confused about how to report stratified data for measures that require the reporting of multiple rates, so an example was provided to clarify that this information should be uploaded to the attachment facility.	No