New Performance Measures with Special Importance for CYSHCN
By Reem M. Ghandour, DrPH, MPA
Ashley Hirai, PhD
Office of Epidemiology and Research, Maternal & Child Health Bureau/HRSA
As part of the recent transformation of the Title V MCH Services Block Grant, a new set of National Performance Measures (NPMs) were developed in partnership with states, families and other stakeholders. With their FY 2016 application due Jul. 15, 2015, grantees will develop annual performance objectives for eight of 15 NPMs to work toward over the next five years. In addition to the two health care quality measures specific to the CYSHCN population domain (medical home and transition), developmental screening and adequate insurance are of special importance in identifying and promoting appropriate health care access for CYSHCN (see table 1). All NPMs will be tracked by CYSHCN status, where possible.
The four NPMs with special relevance to CYSHCN, along with five other NPMs will be tracked using the redesigned National Survey of Children's Health (NSCH). The new NSCH will reflect three fundamental changes: 1) annual administration, instead of every four years; 2) merged content from the previous NSCH and National Survey of Children with Special Health Care Needs (NS-CSHCN); and 3) a shift from a telephone survey to a mailed survey with an online response option. The change in survey mode was the primary driver for the redesign due to the increasing prevalence of households without landline phones and declining response rates.
A pretest of the redesigned NSCH will be conducted summer 2015 to test opportunities to maximize participant response. The survey will then be fielded in 2016, yielding both national and state-level estimates in late spring 2017. National estimates will be produced annually with new state-level estimates produced annually as two-three year rolling estimates beginning in 2018 or 2019. The NSCH will continue to serve as a critical data source for the nation and states in monitoring and identifying opportunities for improving the health of all children, including those with special health care needs. With more timely data, the NSCH will become an even stronger resource to inform and evaluate state action to improve children's health.
| 6 | Developmental Screening | Percent of children, ages 10 through 71 months, receiving a developmental screening using a parent-completed screening tool | Screening must include questions regarding child's language and social development | Data will now be collected for children aged 9-71 months to be consistent with AAP guidelines. |
| 11 | Medical Home | Percent of children with and without special health care needs having a medical home | Medical home includes 19 different items within 5 subcomponents (personal doctor/nurse, usual source of sick and well care, getting needed referrals, family-centered care, care coordination when needed) | No change. |
| 12 | Transition | Percent of adolescents with and without special health care needs who received services necessary to make transitions to adult health care | Necessary services include discussion of shift to adult provider, future health care needs, and future insurance needs if necessary, and age-appropriate self-care | Newly captured for non- CYSHCN. Content has been significantly revised and expanded to capture information on: planning for future; making positive health choices; managing health and health care; understanding changes when transitioning from pediatric to adult care; and development of a transition plan. |
| 15 | Adequate Insurance | Percent of children ages 0 through 17 who are adequately insured | Adequate insurance includes coverage that usually/always meets child's health needs, allows the child to see needed providers, and has reasonable out-of-pocket costs | No change to overall insurance adequacy measures. A new item on adequacy of coverage specifically for mental or behavioral health services has been added. |
Baseline Data from NSCH 2011-2012 and NS-CSHCN 2009-2010*