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41. Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/research/publications/search.html?page=5
    July 01, 2017 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Publication Date: July 2017 Publication Number: 17-M018-1-EF All-Payer Claims … large-scale databases that systematically collect professional, facility, pharmacy, laboratory, and dental claims … Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims … Databases AHRQ funded the All-Payer Claims Databases (APCDs) project to learn more about how APCDs

42. Section 6-B, Table 6 (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-0138-section-6b.pdf
    December 01, 2013 - Validity Table 6: Michigan Validation Testing (Claims Data vs. … Antibiotic Prescriptions for Children with Sickle Cell Disease Antibiotic Prescription in Medicaid Claims … Medical Record (n=34) Yes No Total Yes No 30 4 0 0 30 4 Total 34 0 34 Note: Claims

43. Transcranial Doppler Ultrasonography Screening Among Children With Sickle Cell Anemia (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-139-fullreport.pdf
    May 01, 2017 - This measure is part of the QMETRIC Sickle Cell Disease Administrative Claims set. 3. … For children who have dual enrollment in other health plans, their claims may not be complete since … Administrative claims If other, please list all other data sources in the field below. … Data Collection Strategy This measure was tested using Medicaid administrative claims data. … This measure is implemented with Medicaid administrative claims data.

44. Appropriate Antibiotic Prophylaxis for Children With Sickle Cell Disease (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-0138-fullreport.pdf
    April 01, 2018 - This measure is part of the Q-METRIC Sickle Cell Disease Administrative Claims set. 3. … Administrative data (e.g., claims data). … This measure is based on administrative claims data. … This measure is implemented with administrative claims data. … This measure is implemented with Medicaid administrative claims data.

45. Measure: Pediatric Lower Respiratory Infection (LRI) Readmission Measure (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra_1415-p008-2-ef.pdf
    January 01, 2015 - Administrative data (e.g., claims data). … 30-day readmissions measures. 3 Measure Testing This measure used four large, administrative claims … non-children’s hospitals ● 2005–2009 AHRQ revisit data for New York and Nebraska, which include claims … National Association of Children’s Hospitals and Related Institutions case-mix data, which include claims … ● Claims data are limited as billing codes do not reflect certain information such as disease severity

46. Measure: Pediatric All-Condition Readmission Measure (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra_14-p008-1-ef.pdf
    October 01, 2014 - Administrative data (e.g., claims data). … Measure Testing This measure used four large, administrative claims datasets to develop and evaluate … the measure:13 ● 2008 Medicaid Analytic eXtract (MAX) data for 26 States, which include Medicaid claims … ● 2005-2009 AHRQ Revisit data for New York and Nebraska, which include claims for all payers from … National Association of Children's Hospitals and Related Institutions case-mix data, which include claims

47. Improvement Data | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/pqmp/implementation-qi/toolkit/tcd/improvement-data.html
    July 01, 2021 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Measure performance rates for all levels were calculated using state Medicaid administrative claims … York Department of Health provided measure performance rates using their own Medicaid administrative claims … One difficulty with using state administrative claims is the delay in data availability. … Michigan Medicaid claims data become available approximately 6 months following the end of the year.

48. Measure: Attention Deficit Hyperactivity Disorder (ADHD) - Measure of Chronic Care Followup (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra-1416-p005-3-ef.pdf
    October 01, 2015 - ● Data for this measure are reliably available in administrative claims data. … Measure ● Measure reliability was assessed by implementing the measure in a large, administrative claims … database that included administrative claims data from both Medicaid and commercial payment model … Caveats ● The measure uses administrative claims data and is therefore subject to all issues related … to administrative claims-based measures, including long continuous coverage requirements, lack of

49. CHIPRA 194: Section 6, Tables 13-14 (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-194-section-6-tables-13-14.pdf
    April 17, 2019 - Contingency Table for Presence of Signs or Symptoms of Increased Intracranial Pressure in Administrative Claims … Total 18 137 155 Table 14: Contingency Table for Presence of Lumbar Puncture in Administrative Claims

50. Overuse of Imaging for the Evaluation of Children with Post-Traumatic Headache (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-195-fullreport.pdf
    December 17, 2019 - This measure uses administrative claims data to identify the eligible population for medical record … Administrative claims data; paper and electronic clinical data; paper and electronic health record ( … Using administrative claims, identify the population eligible for the denominator. … Using administrative claims, exclude individuals with ICD-9-CM codes associated with child abuse and … Many denominator and numerator exclusions were not adequately captured in administrative claims.

51. Children with Disabilities Algorithm (CWDA) A Claims-Based Tool for Identifying Children with Disabilities (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-144-section-2.pdf
    January 01, 2020 - Children with Disabilities Algorithm (CWDA) A Claims-Based Tool for Identifying Children with Disabilities … &indata out=claims;by &sid &claimid; run; data claims(keep=&sid &claimid cwda3_gt75); set … claims(keep=&sid &claimid &icdvar.1-&icdvar. … &claimid then output; run; proc sort data=claims; by &sid; data out. … &outdata(keep=&sid cwda); set claims; by &sid; retain cwda3_gt75_sum; if first.

52. Materials VI-B (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-164-materials-vi-b.pdf
    March 09, 2017 - 9.285 8.281 10.411 6.134 6.077 6.191 5.156 5.101 5.211 9.676 9.458 9.898 8.513 8.348 Dental Prophy Claims … Service) Well Child Visit 0.0486 <.0001 Dental Prophy‐At least one claim 0.4146 <.0001 Dental Prophy Claims … 0.4729 <.0001 3+ 0.99 <.0001 Fluoride Treatment‐At least one claim 0.4047 <.0001 Fluoride Treatment Claims … <.0001 Fluoride Treatment Medical Provider‐At least one claim ‐0.0134 0.0368 Fluoride Treatment Claims … 0.0472 0.4973 Fluoride Treatment Dental Provider‐At least one claim 0.3632 <.0001 Fluoride Treatment Claims

53. Measure 1, Section 2, Attachment 6 (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-88-measure-1-section-2-attachment-6.pdf
    January 17, 2017 - Form Measure 1: Accurate ADHD Diagnosis Section 2: Detailed Measure Specifications Attachment 6: Claims … DATA SOURCE Administrative Claims Data 1. Inpatient 2. Outpatient D. … Form Measure 1: Accurate ADHD Diagnosis Section 2: Detailed Measure Specifications Attachment 6: Claims … Disclaimer: This is only an example of how a specification could be constructed from administrative claims

54. Lessons from the Field: Identifying Measurement Challenges and Successes (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/lessons/lessons-challenges-successes.pdf
    January 01, 2019 - While the majority of data used to measure quality come from health care claims submitted by providers … A state medical director noted her state’s success in linking claims and vital statistics records, … •Q-METRIC: measure uses claims data, and is reported and assessed only annually (at state and health … • While there is a lag in claims data availability at the state level, the Q-METRIC team found … plan-level claims data for calculating more timely performance scores

55. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Report (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-fullreport.pdf
    November 01, 2019 - Ratio of MRI to CT Using Administrative Claims Data After applying claims-based exclusions to cases … This measure is specified using administrative claims. … This measure requires administrative claims data. … This measure requires administrative claims data. … This measure is specified using administrative claims.

56. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Headache (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-196-fullreport.pdf
    January 01, 2020 - Ratio of MRI to CT Using Administrative Claims Data After applying claims-based exclusions to cases … This measure is specified using administrative claims. … This measure requires administrative claims. … This measure requires administrative claims data. … This measure is specified using administrative claims.

57. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Technical Specifications (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-technicalspecs.pdf
    October 29, 2019 - This measure requires administrative claims data and is calculated as follows: The ratio of the number … The determination of the eligible population for this measure requires administrative claims data … Table IMG9) or the presence of an E-code) on the day of or within the 7 days prior to imaging (from claims

58. Appendix C. Obstacles to Impact Analysis of Category C Projects | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/final-report/appc.html
    October 01, 2015 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … would be unable to assess some of the key outcomes (for example, BMI screening) through analysis of claims … to the new data system (the Transformed Medicaid Statistical Information System, or T-MSIS) for all claims … Illinois halted MSIS production beyond that date and will not provide 2014 claims until CMS has transitioned … to and validated the T-MSIS claims, the timeline of which has been delayed and remains unknown.

59. Chipra204-Materials Iiia (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/CHIPRA204-Materials_IIIA.pdf
    January 01, 2014 - Developer Measure Title Measure Description Type of Measure/Level of Measurement Data Source Claims … Process Administrative Claims & Medical Records ¥ Claims data: CPT code 96110 (Developmental testing … Important Note about Appropriate Use of Claims Data: This measure is anchored to standardized tools … Claims NOT Included in This Measure: It is important to note that modified 96110 claims [e.g. modifiers … Process Administrative Clinical Data or Paper Medical Records Claims/encounters that identify

60. Chipra205-Materials Iiia (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/CHIPRA205-Materials_IIIA.pdf
    January 01, 2014 - Developer Measure Title Measure Description Type of Measure/Level of Measurement Data Source Claims … Process Administrative Claims & Medical Records ¥ Claims data: CPT code 96110 (Developmental testing … Important Note about Appropriate Use of Claims Data: This measure is anchored to standardized tools … Claims NOT Included in This Measure: It is important to note that modified 96110 claims [e.g. modifiers … Process Administrative Clinical Data or Paper Medical Records Claims/encounters that identify