University of Vermont

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Shaw and VCHIP Partner with UCSF on $13 Million Children’s Quality Measures Study

Judy Shaw, Ed.D, M.P.H., R.N.
Judith Shaw, Ed.D, M.P.H., R.N., Executive Director of the Vermont Child Health Improvement Program (VCHIP) and Professor of Pediatrics and Nursing (Photo: LCOM Design & Photography)

The Vermont Child Health Improvement Program (VCHIP) and Judith Shaw, Ed.D., M.P.H., R.N., executive director of the VCHIP and University of Vermont professor of pediatrics and nursing, will play a significant role in a $13.4 million multicenter pediatric quality measures study funded by the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS).

The four-year grants were distributed in October to six new Pediatric Quality Measures Program (PQMP) grantees focused on implementing new pediatric quality measures developed by the PQMP Centers of Excellence (COE). The Vermont team will work in partnership with University of California San Francisco colleagues Michael Cabana, M.D., M.P.H., professor of pediatrics, and Naomi Bardach, M.D., associate professor of pediatrics, for the project.

Quality measures are used to evaluate or quantify specific health care processes, outcomes, patient perceptions, or other factors related to health care delivery. The pediatric quality measures are used by state Medicaid and Children’s Health Insurance Programs (CHIP) and other public and private programs, providers, plans, patients, and their families to measure and improve the quality of children’s health care.

The UCSF team will focus on asthma and sickle cell measures. In Vermont, researchers will spend the first year assessing the usability of pediatric asthma PQMP measures based on 1) the rate of emergency department (ED) visit use, 2) primary care connection prior to ED visits, and 3) primary care connection after ED visits. Over the following three years, the VCHIP team will be conducting improvement activities aimed at improving asthma care as reflected in findings in these measures. Their process, says Shaw, will include examination of the measures, discussion about the usability, a refinement of the measures, and finally, work on improvement to impact the measure.

“The overarching goal of this work is to rigorously evaluate and refine the PQMP measures so that they can be appropriately applied by practitioners, administrators and purchasers to improve health care quality,” says Shaw, who adds that the PQMP measures were developed to fill the gap in pediatric measurement and AHRQ is providing funding to evaluate the usability and implementation of these measures. Shaw will serve as the Quality Improvement expert for both Vermont and UCSF.

The PQMP was initially established in 2011 by AHRQ and CMS under Title IV of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) with the aim of increasing the portfolio of evidence-based, consensus pediatric quality measures available to public and private purchasers of children’s health care services. The initial phase of the PQMP funded seven COEs to develop new and innovative pediatric measures. This next phase of work will implement and test these newly developed pediatric measures in real-world settings to learn more about how they work when used in the front lines of care.

The new grantees will have two key goals focused on assessing the feasibility and usability of the new measures within the Medicaid and CHIP patient populations at the state, health plan, and provider levels to support performance monitoring and quality improvement.  

“The PQMP Centers of Excellence provided us with valid measures of children’s health care quality. This next step of research will help us test these measures in real-world settings,” said AHRQ Director Andy Bindman, M.D. “The ultimate goal is to improve children’s health through better health care, at lower costs, at both the Federal and state level.” 

“Medicaid and CHIP give millions of children in the United States a healthy start.  Through efforts such as this Pediatric Quality Measures Program funding, we are able to advance states’ efforts to measure and report meaningful improvements in the quality of care for children,” said Vikki Wachino, Director, Center for Medicaid and CHIP Services (CMCS).

This new effort is funded through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), (Public Law 114-10 Section 304(b)), which provided continued funding for the Pediatric Quality Measure Program to build knowledge and evidence to support performance monitoring and quality improvement for children in Medicaid and CHIP.

Learn more about the PQMP here.

(This article was adapted from a press release produced by the AHRQ Public Affairs and CMS Public Affairs offices.)