Developing Quality Measures for Medicaid Beneficiaries with Schizophrenia: Final Report. 1. Environmental Scan: Identify Appropriate Measure Topics and Concepts


The process for identifying the measure concepts included a review of the clinical literature prepared by ASPE, an environmental scan of treatment measure guidelines and existing measures by NCQA, and consultation with experts. We focused on measure concepts in three treatment domains specified by ASPE: pharmacotherapy, psychosocial treatment, and physical health. Drs. Julie Kreyenbuhl and Lisa Dixon, leaders of the Schizophrenia PORT at the University of Maryland School of Medicine, served as content experts and consultants to the project. Their role was to identify potential errors of interpretation, emphasis, inclusion, or omission prior to developing a report that summarized the scientific literature, clinical guidelines, and existing measures that are focused on the population of interest.

The environmental scan identified systematic reviews (e.g., the Schizophrenia PORT reviews), measure specifications, and treatment guidelines and standards developed by professional societies and measurement organizations that relate to care for people with schizophrenia (Buchanan et al. 2010; Dixon et al. 2010). ASPE also conducted a supplemental review of the clinical literature restricted to human adult clinical trials, and in the case of pharmacologic agents, those that have advanced beyond preliminary safety and efficacy testing (Sherry 2010). Because the PORT recommendations include only studies published through March 2008, the ASPE literature review identified more recent studies. In addition, we consulted with a multistakeholder TAG. To identify existing measures assessing care for people with schizophrenia, we searched measure databases from the NQF, the National Quality Measures Clearinghouse, the National Registry of Evidence-Based Programs and Practices through the Substance Abuse and Mental Health Services Administration, and the Center for Quality Assessment and Improvement in Mental Health. Measures were organized by the measure steward, name, description, numerator, denominator, data source, and measurement domain (that is, physical health, pharmacotherapy, and psychosocial interventions). The final measure concepts are presented in Chapter III.

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