Cms-10434 #26 Cqm2018-cis-ch

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

Medicaid and CHIP Program (MACPro)
CQM 2018 - Childhood Immunization Status (CISCH) Core Measure PRA Document
Version 1.0
06/29/2018

Document Number: 392-CQM 2018-CIS-CH-PRA-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

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Table of Contents

Table of Contents
1. Childhood Immunization Status (CIS-CH) 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
1.13
1.14
1.15
1.16
1.17
1.18
1.19
1.20
1.21

Are you reporting on this measure? ................................................................ 1
Measurement Specifications – Path 1 ............................................................. 1
Measurement Specifications – Path 2 ............................................................. 1
Data Source .................................................................................................... 2
Date Range ..................................................................................................... 2
Definition of Population Included in the Measure ............................................ 3
Performance Measure - Path 1 – Screenshot 1 .............................................. 4
Performance Measure - Path 1 – Screenshot 2 .............................................. 5
Performance Measure - Path 1 – Screenshot 3 .............................................. 6
Performance Measure - Path 1 – Screenshot 4 .............................................. 7
Performance Measure – Path 2- Screenshot 1 ............................................... 8
Performance Measure – Path 2 – Screenshot 2 ............................................. 8
Performance Measure – Path 2 – Screenshot 3, 4, 5 ..................................... 9
Deviations from Measure Specifications – Path 1-Screenshot 1 ................... 11
Deviations from Measure Specifications – Path 1- Screenshot 2 .................. 12
Deviations from Measure Specifications- Path 2 ........................................... 12
Combined Rate(s) from Multiple Reporting Units .......................................... 13
Additional Notes/Comments on Measure ...................................................... 13
Optional Measure Stratification – Screenshot 1 ............................................ 14
Optional Measure Stratification – Screenshot 2 ............................................ 15
Optional Measure Stratification – Screenshot 3 ............................................ 15

Appendix A: Acronyms ............................................................................................... 16

List of Figures
Figure 1: Are you reporting on this measure? ................................................................. 1
Figure 2: Measurement Specifications – Path 1 .............................................................. 1
Figure 3: Measurement Specifications – Path 2 .............................................................. 1
Figure 4 : Data Source .................................................................................................... 2
Figure 5: Date Range ...................................................................................................... 2
Figure 6: Definition of Population Included in the Measure ............................................. 3
Figure 7: Performance Measure - Path 1 – Screenshot 1 ............................................... 4
Figure 8: Performance Measure - Path 1 – Screenshot 2 ............................................... 5
Figure 9: Performance Measure - Path 1 – Screenshot 3 ............................................... 6

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List of Tables

Figure 10: Performance Measure - Path 1 – Screenshot 4 ............................................. 7
Figure 11: Performance Measure – Path 2- Screenshot 1 .............................................. 8
Figure 12: Performance Measure – Path 2 – Screenshot 2 ............................................ 8
Figure 13: Performance Measure – Path 2- Screenshot 3 .............................................. 9
Figure 14: Performance Measure – Path 2- Screenshot 4 .............................................. 9
Figure 15: Performance Measure – Path 2- Screenshot 5 ............................................ 10
Figure 16: Deviations from Measure Specifications – Path 1 Screenshot 1 .................. 11
Figure 17: Deviations from Measure Specifications – Path 1 - Screenshot 2 ................ 12
Figure 18: Deviations from Measure Specifications – Path 2 ........................................ 13
Figure 19: Combined Rate(s) from Multiple Reporting Units ......................................... 13
Figure 20: Additional Notes/Comments on Measure (Optional) .................................... 13
Figure 21: Optional Measure Stratification – Screenshot 1 ........................................... 14
Figure 22: Optional Measure Stratification – Screenshot 2 ........................................... 15
Figure 23: Optional Measure Stratification – Screenshot 3 ........................................... 15

List of Tables
No table of figures entries found.

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Are you reporting on this measure?

1. Childhood Immunization Status (CIS-CH) Screenshots
1.1

Are you reporting on this measure?

Figure 1: Are you reporting on this measure?

1.2

Measurement Specifications – Path 1

Figure 2: Measurement Specifications – Path 1

1.3

Measurement Specifications – Path 2

Figure 3: Measurement Specifications – Path 2

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1.4

Data Source

Data Source

Figure 4 : Data Source

1.5

Date Range

Figure 5: Date Range

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1.6

Definition of Population Included in the Measure

Definition of Population Included in the Measure

Figure 6: Definition of Population Included in the Measure

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1.7

Performance Measure - Path 1 – Screenshot 1

Performance Measure - Path 1 – Screenshot 1

Figure 7: Performance Measure - Path 1 – Screenshot 1

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1.8

Performance Measure - Path 1 – Screenshot 2

Performance Measure - Path 1 – Screenshot 2

Figure 8: Performance Measure - Path 1 – Screenshot 2

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1.9

Performance Measure - Path 1 – Screenshot 3

Performance Measure - Path 1 – Screenshot 3

Figure 9: Performance Measure - Path 1 – Screenshot 3

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Performance Measure - Path 1 – Screenshot 4

1.10 Performance Measure - Path 1 – Screenshot 4

Figure 10: Performance Measure - Path 1 – Screenshot 4

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Performance Measure – Path 2- Screenshot 1

1.11 Performance Measure – Path 2- Screenshot 1

Figure 11: Performance Measure – Path 2- Screenshot 1

1.12 Performance Measure – Path 2 – Screenshot 2

Figure 12: Performance Measure – Path 2 – Screenshot 2

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Performance Measure – Path 2 – Screenshot 3, 4, 5

1.13 Performance Measure – Path 2 – Screenshot 3, 4, 5

Figure 13: Performance Measure – Path 2- Screenshot 3

Figure 14: Performance Measure – Path 2- Screenshot 4

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Performance Measure – Path 2 – Screenshot 3, 4, 5

Figure 15: Performance Measure – Path 2- Screenshot 5

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Deviations from Measure Specifications – Path 1-Screenshot 1

1.14 Deviations from Measure Specifications – Path 1-Screenshot 1

Figure 16: Deviations from Measure Specifications – Path 1 Screenshot 1

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Deviations from Measure Specifications – Path 1- Screenshot 2

1.15 Deviations from Measure Specifications – Path 1- Screenshot 2

Figure 17: Deviations from Measure Specifications – Path 1 - Screenshot 2

1.16 Deviations from Measure Specifications- Path 2
Note: Same N/D/R sets are displayed under each of the specification categories shown above

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Combined Rate(s) from Multiple Reporting Units

Figure 18: Deviations from Measure Specifications – Path 2

1.17 Combined Rate(s) from Multiple Reporting Units

Figure 19: Combined Rate(s) from Multiple Reporting Units

1.18 Additional Notes/Comments on Measure

Figure 20: Additional Notes/Comments on Measure (Optional)

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Optional Measure Stratification – Screenshot 1

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

Figure 21: Optional Measure Stratification – Screenshot 1

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Optional Measure Stratification – Screenshot 2

1.20 Optional Measure Stratification – Screenshot 2

Figure 22: Optional Measure Stratification – Screenshot 2

1.21 Optional Measure Stratification – Screenshot 3

Figure 23: Optional Measure Stratification – Screenshot 3

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Optional Measure Stratification – Screenshot 3

Appendix A: Acronyms
Table 1: Acronyms
Acronym

Definition

CQM

Child Quality Measures

PRA

Paperwork Reduction Act of 1995

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