Cms-10434 #26 Cqm2017-ima

Centers for Medicare & Medicaid
Services
CMS eXpedited Life Cycle (XLC)

Medicaid and CHIP Program (MACPro)
CQM 2017 - Immunizations for Adolescents (IMA)
Core Measure PRA Document
Version 1.0
08/28/2017

Document Number: 268-QSSI-MACPro-PRA-CQM2017-IMA-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

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Table of Contents

Table of Contents
1. Immunizations for Adolescents (IMA) Screenshots ............................................. 1
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12

Measurement Specifications – Path 1 ............................................................. 1
Measurement Specifications – Path 2 ............................................................. 1
Data Source .................................................................................................... 1
Performance Measure – Path 1 – Screenshot 1 ............................................. 2
Performance Measure – Path 1 – Screenshot 2 ............................................. 2
Performance Measure – Path 2 ...................................................................... 3
Deviations from Measure Specifications – Screenshot 1 ................................ 4
Deviations from Measure Specifications – Screenshot 2 ................................ 4
Deviations from Measure Specifications – Screenshot 3 ................................ 5
Deviations from Measure Specifications – Screenshot 4 ................................ 5
Optional Measure Stratification – Screenshot 1 .............................................. 6
Optional Measure Stratification – Screenshot 2 .............................................. 7

Appendix A: Acronyms ................................................................................................. 8

List of Figures
Figure 1: Measurement Specifications – Path 1 .............................................................. 1
Figure 2: Measurement Specifications – Path 2 .............................................................. 1
Figure 3 : Data Source .................................................................................................... 1
Figure 4: Performance Measure – Path 1 – Screenshot 1 .............................................. 2
Figure 5: Performance Measure – Path 1 – Screenshot 2 .............................................. 2
Figure 6: Performance Measure – Path 2 ....................................................................... 3
Figure 7: Deviations from Measure Specifications – Screenshot 1 ................................. 4
Figure 8: Deviations from Measure Specifications – Screenshot 2 ................................. 4
Figure 9 : Deviations from Measure Specifications – Screenshot 3 ................................ 5
Figure 10: Deviations from Measure Specifications – Screenshot 4 ............................... 5
Figure 11 : Optional Measure Stratification – Screenshot 1 ............................................ 6
Figure 12: Optional Measure Stratification – Screenshot 2 ............................................. 7

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List of Tables

List of Tables
No table of figures entries found.

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Measurement Specifications – Path 1

1. Immunizations for Adolescents (IMA) Screenshots
1.1

Measurement Specifications – Path 1

Figure 1: Measurement Specifications – Path 1

1.2

Measurement Specifications – Path 2

Figure 2: Measurement Specifications – Path 2

1.3

Data Source

Figure 3 : Data Source

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1.4

Performance Measure – Path 1 – Screenshot 1

Performance Measure – Path 1 – Screenshot 1

Figure 4: Performance Measure – Path 1 – Screenshot 1

1.5

Performance Measure – Path 1 – Screenshot 2

Figure 5: Performance Measure – Path 1 – Screenshot 2

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1.6

Performance Measure – Path 2

Figure 6: Performance Measure – Path 2

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Deviations from Measure Specifications – Screenshot 1

Deviations from Measure Specifications – Screenshot 1

Figure 7: Deviations from Measure Specifications – Screenshot 1

1.8

Deviations from Measure Specifications – Screenshot 2

Figure 8: Deviations from Measure Specifications – Screenshot 2

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1.9

Deviations from Measure Specifications – Screenshot 3

Deviations from Measure Specifications – Screenshot 3

Figure 9 : Deviations from Measure Specifications – Screenshot 3

1.10 Deviations from Measure Specifications – Screenshot 4

Figure 10: Deviations from Measure Specifications – Screenshot 4

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Optional Measure Stratification – Screenshot 1

1.11 Optional Measure Stratification – Screenshot 1
Note: Same N/D/R sets are displayed under each of the stratification categories

Figure 11 : Optional Measure Stratification – Screenshot 1

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Optional Measure Stratification – Screenshot 2

1.12 Optional Measure Stratification – Screenshot 2

Figure 12: Optional Measure Stratification – Screenshot 2

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Optional Measure Stratification – Screenshot 2

Appendix A: Acronyms
Table 1: Acronyms
Acronym

Definition

CQM

Child Quality Measures

PRA

Paperwork Reduction Act of 1995

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