The Family Experiences with Coordination of Care (FECC) Survey was developed to gather information about the quality of care coordination being received by children with medical complexity (CMC) over the previous 12 months. The FECC Survey is completed by English- and Spanish-speaking caregivers of CMC aged 0-17 years with at least 4 medical visits in the previous year, and it includes all of the information needed to score 20 separate and independent quality measures, a sub-set of 8 of which are included in this submitted measure set. CMC are identified from administrative data using the Pediatric Medical Complexity Algorithm (PMCA)1, which uses up to 3 years’ worth of International Classification of Diseases—9th Revision (ICD-9) codes to classify a child’s illness with regard to chronicity and complexity. CMC are children identified by the PMCA as having complex, chronic disease.
The full NQF submission includes a set of 8 of the FECC quality measures; this submission relates to FECC 7, described below. The short descriptions of each quality measure follows; full details are provided in the Detailed Measure Specifications (see S.2b):
2842: FECC-1: Has care coordinator
2843: FECC-3: Care coordinator helped to obtain community services
2844: FECC-5: Care coordinator asked about concerns and health changes
2845: FECC-7: Care coordinator assisted with specialist service referrals
2846: FECC-8: Care coordinator was knowledgeable, supportive and advocated for child’s needs
2847: FECC-9: Appropriate written visit summary content
2849: FECC-15: Caregiver has access to medical interpreter when needed
2850: FECC-16: Child has shared care plan
Each of the quality measures is scored on a 0-100 scale, with higher scores indicating better care. For dichotomous measures, a score of 100 indicates the child received the recommended care; a score of 0 indicates that they did not. Please see Detailed Measure Specifications (see S.2b) for additional measure-specific scoring information.
- Measure TypeElectronic Clinical Quality Measure (eCQM)Level Of AnalysisCare SettingNumerator
The numerator for FECC-7 is specified in the Detailed Measure Specifications (see S.2b). A brief description of each numerator is laid out in Table 1 in section De.3, and a more detailed description of FECC-7 follows:
FECC-7: Caregivers of CMC who report having a care coordinator for their child should also report that the care coordinator assists them with specialty service referrals by ensuring that the appointment with the specialty service provider occursDenominatorThe eligible population of caregivers for the FECC Survey overall is composed of those who meet the following criteria:
1. Parents or legal guardians of children 0-17 years of age
2. Child classified as having a complex, chronic condition using the Pediatric Medical Complexity Algorithm (PMCA) (see Simon TD, Cawthon ML et al. 2014)
3. Child had at least 4 visits to a healthcare provider over the previous year
While some of the FECC measures only apply to a subset of the overall eligible population for the survey (e.g., measures related to the quality of care coordination services provided are only scored for those caregivers who endorse having a care coordinator), eligibility for these quality measures can only be gleaned from responses to the FECC Survey itself. This is analogous to the situation with many H-CAHPS measures, where, for example, measures about blood draws and laboratory testing are scored only for those who had the relevant service performed during the time frame or hospitalization in question.ExclusionsDenominator exclusions:
1. Child had died
2. Caregiver spoke a language other than English or SpanishTesting Data Sources
- Measure StructureNon Condition SpecificTarget PopulationMeasure Selection AttributesNational Quality Strategy PrioritiesEffective Communication and Care CoordinationPerson- and Family-Centered Care
- Risk Adjustment
- Current or planned use(s)Planned Use
- Most Recent Endorsement ActivityEndorsed Pediatric Performance MeasuresInitial EndorsementEndorsement StatusLast Updated
- Steward Organization Email