Title V National Performance Measures and the Affordable Care Act Including the MCH Population Domains
National
Performance
Measure
(NPM)
number
NPM
National
Performance
Priority Areas
MCH Population
Domain
Applicable ACA provision
1
Percent of women with a past
year preventive visit
Well-woman visit
Women/maternal
health

Health plans are required to cover preventive services with an A or B rating from the USPSTF.
There is no cost sharing for those services.
2
Percent of cesarean deliveries
among low-risk first births
Women/maternal
health


Could be part of the Medicaid core set of quality measures
Strong Start for Mothers and Newborns Initiative
3
Percent of very low birth
weight (VLBW) infants born in
a hospital with a Level III +
Neonatal Intensive Care Unity
(NICU)
A) Percent of infants who are
ever breastfed and B)Percent
of infants breastfed exclusively
through 6 months
Low-risk
cesarean
delivery
Perinatal
regionalization
Perinatal/infant health

Coverage of maternity benefits as an essential health benefit (EHB) in marketplace plans
Breastfeeding
Perinatal/infant health


Breastfeeding: coverage of support/counseling and equipment w/o cost sharing under preventive
services, Workplace accommodations: Break-time requirement for nursing mothers (place to
pump, reasonable time to pump).
Prevention and Public Health Fund

Coverage of all Bright Futures preventive services without cost sharing
4
5
Percent of infants placed to
sleep on their backs
Safe sleep
Perinatal/infant health
6
Percent of children, ages 10
through 71 months, receiving a
developmental screening using
a parent-completed screening
tool
Developmental
screening
7
Rate of hospitalization for nonfatal injury per 100,000
children ages 0 through 9 and
adolescents ages 10 through
19
Injury
Child health and/or
adolescent health
8
Percent of children ages 6
through 11 and adolescents
ages 12 through 17 who are
physically active at least 60
minutes per day
Percent of adolescents, ages
12 through 17, who are bullied
or who bully others
Physical activity
Child health and/or
adolescent health
Bullying
10
Percent of adolescents, ages
12 through 17, with a
preventive medical visit in the
past year
11
12
9
Child health


Coverage of all Bright Futures preventive services without cost sharing which includes
developmental
Preventive services for children w/o cost sharing. Developmental screening up to age three and
surveillance throughout childhood








Violence and injury prevention counseling in Bright Futures guidelines;
Injury prevention counseling in MIECHV encounters.
The law allows young adults to stay on parents plans until age 26,
Medicaid health home option for states,
community-based health teams
Coverage of Bright Futures guidelines which includes promotion of healthy weight
BMI screening covered without cost sharing
Prevention and Public Health Fund
o Community Transformation Grants
Adolescent health


Depression screening for adolescents covered as a preventive service
Coverage of Bright Futures guidelines which includes violence and injury prevention, which
includes bullying
Adolescent wellvisit
Adolescent health




Coverage of Bright Futures with no cost-sharing,
Young adults coverage on parental plans until age 26,
Medicaid medical home option for states,
Community-based health teams
Percent of children with and
without special health care
needs having a medical home
Medical home
Children with special
health care needs






Medicaid health homes
CMMI funding for systems and payment reform,
Community-based collaborative care network program,
Pediatric ACO demonstration project,
Community health center expansion,
State grants to promote community health teams to support patient-centered medical homes
Percent of adolescents with
and without special health care
needs who received services
necessary to make transitions
to adult health care
Transition
Children with special
health care needs

Medicaid health homes
13
14
A) Percent of women who had
a dental visit during pregnancy
and B) Percent of children
ages 1 through 17, who had a
preventive dental visit in the
past year
A) Percent of women who
smoke during pregnancy and
B) Percent of children who live
in households where someone
smokes
Oral health
Cross-cutting/ life
course

Dental coverage for children is an EHB but not required to purchase. Not having dental coverage
for children does not subject families to the tax penalty.
Smoking
Cross-cutting/ life
course

Medical Assistance with Smoking and Tobacco Use Cessation" measured in the adult core set of
Medicaid (voluntarily reported),
Covered as part of preventive services without a copayment or co-insurance or meet deductible.
This applies only when these services are delivered by a network provider.
Tobacco use screening and interventions for all adults and cessation for users,
Tobacco use screening and interventions for all women, and expanded counseling for pregnant
tobacco users
Prevention and Public Health Fund
Strong Start for Mothers and Newborns Initiative





15
Percent of children ages 0
through age 17 who are
adequately insured
Adequate
insurance
coverage
Cross-cutting/ life
course



Medicaid eligibility for children raised to minimum of 138% FPL.
Advanced premium tax credits available for purchase of health insurance on the marketplace for
families with income of 100% FPL to 400% FPL
Extended presumptive eligibility beyond children and pregnant women and expands the role of
hospitals in determining eligibility presumptively.
AMCHP resources on each MCH population:
Who's Covered for What in 2015 and Beyond fact sheet http://www.amchp.org/Policy-Advocacy/health-reform/resources/Documents/MCHCoverageandBenefitsFINAL.pdf
Adolescent health: http://www.amchp.org/Policy-Advocacy/health-reform/Documents/Adolescent-Health-ACA-Fact-Sheet.pdf
CYSHCN: http://www.amchp.org/Policy-Advocacy/health-reform/Documents/CYSHCN-ACA-Fact-Sheet.pdf
Breastfeeding: http://www.amchp.org/Policy-Advocacy/health-reform/Documents/AMCHP%20Dec%202013%20Breastfeeding%20Issue%20Brief%20FINAL.pdf
Women: http://www.amchp.org/Policy-Advocacy/health-reform/resources/Documents/Women%27s%20Health%20%20%20ACA%20Fact%20Sheet.pdf
Medical home: http://www.amchp.org/Policy-Advocacy/health-reform/Documents/Medical-Homes-ACA-Fact-Sheet.pdf