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Access to Care

Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey, Version 5.0 (Medicaid and Commercial)

  • The CAHPS Health Plan Survey is a survey that asks health plan enrollees to report about their care and health plan experiences as well as the quality of care received from physicians. HP-CAHPS Version 4.0 was endorsed by NQF in July 2007 (NQF #0006) and Version 5.0 received maintenance endorsement in January 2015. The survey is part of the CAHPS family of patient experience surveys and is available in the public domain at https://www.ahrq.gov/cahps/surveys-guidance/hp/index.html

    CBE ID
    0006

Contraceptive Care - Access to LARC

  • Percentage of women aged 15-44 years at risk of unintended pregnancy that is provided a long-acting reversible method of contraception (i.e., implants, intrauterine devices or systems (IUD/IUS)).

    It is an access measure because it is intended to identify very low rates (less than 1-2%) of long-acting reversible methods of contraception (LARC), which may signal barriers to LARC provision.

    CBE ID
    2904

Contraceptive Care - Postpartum

  • Among women ages 15 through 44 who had a live birth, the percentage that is provided:
    1) A most effective (i.e., sterilization, implants, intrauterine devices or systems (IUD/IUS)) or moderately (i.e., injectables, oral pills, patch, or ring) effective method of contraception within 3 and 60 days of delivery.

    2) A long-acting reversible method of contraception (LARC) within 3 and 60 days of delivery.

    CBE ID
    2902

Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence

  • The percentage of emergency department (ED) visits for members 13 years of age and older with a principal diagnosis of alcohol or other drug (AOD) abuse or dependence, who had a follow up visit for AOD. Two rates are reported:
    - The percentage of ED visits for which the member received follow-up within 30 days of the ED visit (31 total days).
    - The percentage of ED visits for which the member received follow-up within 7 days of the ED visit (8 total days).

    CBE ID
    3488

Follow-Up After Emergency Department Visit for Mental Illness

  • The percentage of emergency department (ED) visits for members 6 years of age and older with a principal diagnosis of mental illness or intentional self-harm, who had a follow-up visit for mental illness. Two rates are reported:
    - The percentage of ED visits for which the member received follow-up within 30 days of the ED visit (31 total days).
    - The percentage of ED visits for which the member received follow-up within 7 days of the ED visit (8 total days).

    CBE ID
    3489

Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence

  • The percentage of discharges for patients 18 years of age and older who had a visit to the emergency department with a primary diagnosis of mental health or alcohol or other drug dependence during the measurement year AND who had a follow-up visit with any provider with a corresponding primary diagnosis of mental health or alcohol or other drug dependence within 7- and 30-days of discharge.

    Four rates are reported:
    - The percentage of emergency department visits for mental health for which the patient received follow-up within 7 days of discharge.

    CBE ID
    2605

Follow-Up Care for Children Prescribed ADHD Medication (ADD)

  • Percentage of children newly prescribed attention-deficit/hyperactivity disorder (ADHD) medication who had at least three follow-up care visits within a 10-month period, one of which is within 30 days of when the first ADHD medication was dispensed.
    An Initiation Phase Rate and Continuation and Maintenance Phase Rate are reported.

    CBE ID
    0108

Frequency of Ongoing Prenatal Care (FPC)

  • The percentage of Medicaid deliveries that had the following number of expected prenatal visits:

    • less than 21 percent of expected visits.

    • 21 percent–40 percent of expected visits.

    • 41 percent–60 percent of expected visits.

    • 61 percent–80 percent of expected visits.

    • greater than or equal to 81 percent of expected visits.

    CBE ID
    1391