Children’s HealthWatch Comments on the Driver of Health Screening Rate and the Driver of Health Screen Positive Rate

On behalf of Children’s HealthWatch, we applaud the National Quality Forum (NQF) Measures Application Partnership’s consideration of MUC 2021-136 (Driver of Health Screening Rate) and MUC 2021-134 (Driver of Health Screen Positive Rate). Children’s HealthWatch seeks to improve the health and development of young children and their families by informing equitable policies that address and alleviate economic hardships and by dismantling systems of institutionalized discrimination and inequity at the root of these hardships. Our work begins with research through interviewing caregivers of young children on the frontlines of pediatric care, in urban emergency departments and primary care clinics in five cities: Boston, Minneapolis, Little Rock, Baltimore, and Philadelphia. Since 1998, we have interviewed over 75,000 caregivers of children under four years of age and analyzed the data to determine the impact of social risk factors (individual-level adverse social determinants of health) and public policies designed to address those social risk factors on the health and development of young children and the well-being of their families. Specifically, our research focuses on the following: nutrition, housing, health care, child care, utilities, income and wealth, employment, Adverse Childhood Experiences and Experiences of Discrimination. Our research – in addition to that of others – shows that lack of access to basic needs is associated with poor child health and development, poor parental physical and mental health, higher child hospitalization rates, and learning and behavioral/emotional impairments. Health consequences are often compounded, as they are frequently experienced simultaneously, often as a result of limited income and resources.

How would adding this measure add value? How would the measure improve patient outcomes?

Based on decades of our research, and the research of others, we stress the importance and value of measuring of social risk factors to identify and address unmet social needs (social needs differ from social risks insofar as they convey the patient’s preferences and priorities regarding the social risk) and enable policymakers and agencies such as CMS and other payers to incorporate them in value-based payment models. The measures under consideration (MUC 2021-136, MUC 2021-134) also offer a valuable opportunity to provide a foundation for comparable measures for the Medicaid Adult and Child Core Measure Set and guidance for states in their efforts to standardize these data.