Improved measurement of the continuity of insurance coverage in the Medicaid and CHIP population is needed to help maximize insurance continuity and coverage for vulnerable children. To further this goal, the AHRQ-CMS CHIPRA PQMP Center of Excellence at the Children’s Hospital of Philadelphia developed the metric Informed Coverage.

This measure assesses the percentage of children with medical complexity age 1 to 17 years old who have a Bice-Boxerman continuity of care index (hereafter referred to as Bice-Boxerman COC index) of >=0.5 in the primary care setting over a 12-month period.

Percentage of patients aged 12 years and older screened for depression on the date of the encounter or 14 days prior to the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the eligible encounter

GAPPS is a measure of the number of preventable adverse events per 1,000 patient-days among pediatric inpatients. It is designed to compare rates across institutions and over time. The GAPPS measure utilizes the GAPPS trigger tool to identify adverse events.

Percentage of patients aged 12 years and older screened for depression on the date of the encounter or 14 days prior to the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the eligible encounter

Percentage of persons > 13 years of age with diagnosed HIV infection who are virally suppressed in the measurement year.

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

Percentage of patients aged 18 years and older with one or more of the following: a history of injection drug use, receipt of a blood transfusion prior to 1992, receiving maintenance hemodialysis, OR birthdate in the years 1945–1965 who received one-time screening for hepatitis C virus (HCV) infection

This measure assesses the proportion of births that have been screened for hearing loss before hospital discharge.

Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved within 90 days following the cataract surgery