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  • Measure Summary
  • NQMC:008642
  • Jul 2013

Patient-centered medical home patients' experiences: percentage of parents or guardians who reported how often their child's provider seemed informed and up-to-date about the care their child got from specialists.

National Committee for Quality Assurance (NCQA). HEDIS 2014: specifications for the CAHPS® PCMH survey. Washington (DC): National Committee for Quality Assurance (NCQA); 2013. various p.

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in November 2015.

Primary Measure Domain

Clinical Quality Measures: Patient Experience

Secondary Measure Domain

Does not apply to this measure

Description

The CAHPS Patient-Centered Medical Home (PCMH) Survey, Child Version provides information on parents' experience with their child's practice. Results summarize patient experiences through an overall rating question, composites and individual question summary rates.

For this measure, parents or guardians reported how often ("Never," "Sometimes," "Usually," or "Always") their child's provider seemed informed and up-to-date about the care they their child got from specialists. This measure is based on the following one question in the CAHPS PCMH Survey, Child Version:

  • Q37: In the last 12 months, how often did [this provider] seem informed and up-to-date about the care your child got from specialists?

Rationale

The National Committee for Quality Assurance's (NCQA's) Committee on Performance Measurement (CPM) has long felt that consumer experience with health care is a critical component of quality of care, that experience affects care outcome—and that experience is itself a measure of outcome.

Evidence for Rationale

National Committee for Quality Assurance (NCQA). HEDIS 2014: specifications for the CAHPS® PCMH survey. Washington (DC): National Committee for Quality Assurance (NCQA); 2013. various p.

Primary Health Components

Patient experience; coordination of care; provider informed about care from specialists; children

Denominator Description

Eligible patients whose parent or guardian answered the question, "In the last 12 months, how often did [this provider] seem informed and up-to-date about the care your child got from specialists?," on the CAHPS Patient-Centered Medical Home (PCMH) Survey, Child Version (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

The number of "Never," "Sometimes," "Usually," and "Always" responses on the question, "In the last 12 months, how often did [this provider] seem informed and up-to-date about the care your child got from specialists?" (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

The National Committee for Quality Assurance (NCQA) worked with the CAHPS Consortium to incorporate input from the Technical Expert Panel (TEP) and the Patient-Centered Medical Home (PCMH) Advisory Committee on survey content and proposed domains. We identified a list of topics and potential items (often drawn from existing surveys) and included these items in the PCMH 2011 call for public comment. We also worked with the CAHPS Consortium to develop new items. The CAHPS Consortium conducted focus groups and cognitive testing in English and Spanish, with adult patients and parents of pediatric patients, and included patients in both medical home practices and in primary care practices not categorized as medical homes.

In fall 2010, the CAHPS Consortium conducted cognitive testing of the CAHPS PCMH Survey. Following this, NCQA conducted a field-test of draft versions of both the adult and child CAHPS PCMH Surveys. The field-test survey included 115 items. In several cases, we included items from existing surveys and new items addressing the same content, using CAHPS principles to maintain a level of question standardization.

After reviewing the results of the field-test, the CAHPS Consortium recommended a 58-item adult questionnaire and a 67-item child questionnaire, both including the Clinician & Group core questions and new PCMH items, and representing a 50 percent reduction in length from the survey prepared for the field-test.

NCQA held a public comment period in June 2011 to elicit feedback from stakeholders. After considering comments, the questionnaires and survey methodology were finalized, consistent with the information in this publication.

Evidence for Extent of Measure Testing

National Committee for Quality Assurance (NCQA). HEDIS 2014: specifications for the CAHPS® PCMH survey. Washington (DC): National Committee for Quality Assurance (NCQA); 2013. various p.

State of Use

Current routine use

Current Use

Care coordination

Decision-making by consumers about health plan/provider choice

Decision-making by managers about resource allocation

Internal quality improvement

Public reporting

Measurement Setting

Patient-centered Medical Homes

Transition

Type of Care Coordination

Coordination across provider teams/sites

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Clinical Practice or Public Health Sites

Statement of Acceptable Minimum Sample Size

Specified

Target Population Age

Age less than or equal to 17 years

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Effective Communication and Care Coordination
Health and Well-being of Communities
Person- and Family-centered Care

IOM Care Need

Getting Better

Living with Illness

Staying Healthy

IOM Domain

Patient-centeredness

Case Finding Period

The measurement period

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Encounter

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Eligible patients whose parent or guardian answered the question, "In the last 12 months, how often did [this provider] seem informed and up-to-date about the care your child got from specialists?," on the CAHPS Patient-Centered Medical Home (PCMH) Survey, Child Version. Include nonresponses.

Note:

  • Eligible Population: Patients 17 years and younger as of the last day of the measurement period who had a visit with a practice clinician during the measurement period (scheduled or walk-in). The clinician need not be the patient's regular clinician or primary care provider.
  • Nonresponses:
    • Refusal
    • After maximum contact attempts

Exclusions

  • Deceased
  • Does not meet eligible population criteria
  • Language barrier

Exclusions/Exceptions

Does not apply to this measure

Numerator Inclusions/Exclusions

Inclusions
The number of "Never," "Sometimes," "Usually," and "Always" responses on the question, "In the last 12 months, how often did [this provider] seem informed and up-to-date about the care your child got from specialists?"

Note:

  • A questionnaire must have the final disposition code of "Complete and Valid Survey" for inclusion in the survey results calculations.
  • Each specific question must be appropriately answered for inclusion in CAHPS Patient-Centered Medical Home (PCMH) Survey results calculations. An appropriately answered question complies with survey and skip-pattern instructions. Refer to the original measure documentation for details.

Exclusions
Inappropriately answered questions are excluded from results calculations. Examples of inappropriately answered questions are:

  • Unanswered questions. The patient skips a question that should have been answered.
  • Questions where the patient selected more than one response (except for questions that permit more than one response).
  • Questions the patient should have skipped based on the response to a gate item. A gate item is a question that instructs the patient to skip subsequent questions based on a particular response.
  • Questions in a skip pattern when the patient does not answer the gate item or provides an invalid answer to a gate item.

Numerator Search Strategy

Fixed time period or point in time

Data Source

Patient/Individual survey

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

CAHPS Patient-Centered Medical Home (PCMH) Survey, Child Version

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Composite/Scale

Frequency Distribution

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

External comparison at a point in, or interval of, time

External comparison of time trends

Internal time comparison

Original Title

In the last 12 months, how often did the provider named in Question 1 seem informed and up-to-date about the care your child got from specialists?

Measure Collection Name

HEDIS 2014: Patient-Centered Medical Home Collection

Measure Set Name

Experience of Care

Measure Subset Name

CAHPS PCMH Survey, Child Version

Submitter

National Committee for Quality Assurance - Health Care Accreditation Organization

Developer

National Committee for Quality Assurance - Health Care Accreditation Organization

Funding Source(s)

Survey development was supported by The Commonwealth Fund, a national, private foundation based in New York City that supports independent research on health care issues and awards grants to improve health care practice and policy.

Composition of the Group that Developed the Measure

Invaluable expertise and guidance was provided by the members of the Technical Expert Panel on Patient Experiences, the Patient-Centered Medical Home (PCMH) Advisory Committee and the CAHPS Consortium.

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

The National Committee for Quality Assurance (NCQA) worked with the CAHPS Consortium, sponsored by the federal Agency for Healthcare Research and Quality (AHRQ), to develop a new version of the CAHPS Clinician & Group Survey to address specific processes of care relevant to patient-centered medical homes (CAHPS Patient-Centered Medical Home [PCMH] Survey).

Date of Most Current Version in NQMC

2013 Jul

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in November 2015.

Source(s)

National Committee for Quality Assurance (NCQA). HEDIS 2014: specifications for the CAHPS® PCMH survey. Washington (DC): National Committee for Quality Assurance (NCQA); 2013. various p.

Measure Availability

Source available for purchase from the National Committee for Quality Measurement (NCQA) Web site External Web Site Policy.

For more information, contact NCQA at 1100 13th Street, NW, Suite 1000, Washington, DC 20005; Phone: 202-955-3500; Fax: 202-955-3599; Web site: www.ncqa.org External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on August 18, 2014.

The information was reaffirmed by the measure developer on November 2, 2015.

Copyright Statement

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

Content adapted and reproduced with permission from the National Committee for Quality Assurance (NCQA). The Patient-Centered Medical Home (PCMH) measures and specifications were developed by and are owned and copyrighted by NCQA. PCMH measures and specifications are not clinical guidelines and do not establish a standard of medical care. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. NCQA disclaims all liability for use or accuracy of any coding contained in the specifications.

Anyone desiring to use or reproduce the measure abstracts without modification for a noncommercial purpose may do so without obtaining any approval from NCQA. All commercial uses of the measure abstracts must be approved by NCQA and are subject to a license at the discretion of NCQA. To purchase copies of the full measures and specifications, which contain additional distribution and use restrictions, contact NCQA Customer Support at 888-275-7585 or visit www.ncqa.org/publications External Web Site Policy.

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