Not all Category 1 measures will be reportable for the measurement year, as reporting on some of these measures will be phased in over the next few years. Measures can be reclassified from P4R to P4P or vice versa through annual CAG and State review or as determined by the MCO and VBP Contractor. Incentives for reporting should be based on timeliness, accuracy, and completeness of data. P4R measures are intended to be used by the MCOs to incentivize VBP Contractors for reporting data to monitor quality of care delivered to members under a VBP contract.Measures can be included in both the determination of the target budget and in the calculation of shared savings for VBP Contractors. In other words, these are the measures on which payments in VBP contracts may be based. P4P measures are intended to be used in the determination of shared savings amounts for which VBP Contractors are eligible.The State classified each Category 1 measure as either P4P or P4R: At least one Category 1 P4P measure must be included in a VBP contract. These measures are also intended to be used to determine the amount of shared savings for which VBP contractors are eligible 1. CATEGORY 3 Measures that are insufficiently relevant, valid, reliable and/or feasible.Ĭategory 1 quality measures as identified by the CAGs and accepted and deemed reportable by the State are to be reported by VBP Contractors to the MCOs. These measures were investigated during the 2017 & 2018 pilot programs. CATEGORY 2 Measures that are clinically relevant, valid, and reliable, but where the feasibility could be problematic. The measures below are classified by category based on an assessment of reliability, validity, and feasibility, and according to suggested method of use (either Pay for Reporting (P4R) or Pay for Performance (P4P)).Ĭategorizing and Prioritizing Quality Measures CATEGORY 1 Approved quality measures that are deemed to be clinically relevant, reliable, valid, and feasible. MEASURE CLASSIFICATIONĮach measure has been designated by the State as Category 1, 2, or 3 with associated recommendations for implementation and testing for future use in VBP Arrangements. This culminates in a total of twenty Category 1 and 2 Children´s Quality Measures. For MY2021, seventeen measures have remained unchanged, three measures were replaced, and two measures have been removed. Upon receiving the CAG recommendations and Task Force feedback, the State defined a final list of measures for consideration for MY2021. The Task Force provides feedback to the Department of Health (DOH) on quality measure feasibility, reporting, and calculation. Members of the Task Force include professionals from various Managed Care Organizations (MCOs), Clinical Subject Matter Experts, and State Agencies, along with other professionals who have experience in quality measurement and health information technology. The goal of the Task Force is to make recommendations to the State to support and inform during the Annual Measure Review Cycle. MEASURE SELECTION AND FEASIBILITYĭuring the spring and fall of 2020, the Children´s Health CAG reconvened and made recommendations to the State on quality measures, data collection, data reporting, and support required for providers to be successful in a VBP environment.īeginning in June of 2017, the State initiated regular meetings of the VBP Measure Support Task Force. The Children´s measure set was designed to encourage providers to meet high standards of patient-centered clinical care and coordination across multiple care settings for the child and adolescent population. The goal of this measure set is to align with measure sets put forth in the Delivery System Reform Incentive Payment (DSRIP) Program, for the Quality Assurance Reporting Requirements (QARR), and the Merit-based Incentive Payment System (MIPS), where applicable. The Measurement Year (MY) 2021 Children´s Quality Measure Set was created in collaboration with the Children´s Health Clinical Advisory Group (CAG), VBP Measure Support Task Force, as well as the New York State (NYS) Value Based Payment (VBP) Workgroup. Measure Set is also available in Portable Document Format (PDF)įebruNYS Medicaid Value Based Payment INTRODUCTION. All Health Care Professionals & Patient SafetyĬhildren's Value Based Payment Quality Measure Set Measurement Year 2021.Clinical Guidelines, Standards & Quality of Care.Health & Safety in the Home, Workplace & Outdoors.Birth, Death, Marriage & Divorce Records.
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