AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care

Quality Indicator Resources

The resources below broadly apply to the Quality Indicator modules and provide valuable background information on their development. They provide information about the life cycle of the AHRQ QIs and related topics, including the methodology used in the software to calculate the QIs. Resources are also available on AHRQ’s process to convert the QIs from ICD-9-CM to ICD-10-CM/PCS.

Quality Indicator Methodology Tools

QI Reporting / Tips for Users

National Quality Forum endorsed indicators

The National Quality Forum (NQF) is an independent, voluntary, consensus-based member organization that endorses standardized quality measures. Below is a list of the AHRQ QIs that are endorsed by the NQF.

Quality Indicator Development

The AHRQ QI measure development process involves four phases. The first phase is candidate indicator development for an identified topic area of interest. This phase has several steps involved in it. Ranging from identification of candidate indicators, and literature reviews to finalization of specifications, and summary of evidence for each recommended candidate indicator. The second phase is implementation of the QIs into the AHRQ QI software, which involves coding the QIs into the software, testing, and developing user documentation. The third phase is maintenance of the QIs, which involves review of the evidence, technical specification updates, periodic clinical panel review, NQF endorsement submission and maintenance, and newly available data and methodological advances. The final phase is retirement which involves evidence, removing coding from software, testing and user documentation.

These phases and processes sometimes may require modifications to meet the needs of indicator development in new areas. The following report provides an in-depth description of AHRQ QI measure development, implementation, maintenance and retirement processes; The reports describes the overall approach to indicator development and outlines the steps taken to develop and maintain indicators.

QI for Home and Community Based Services (HCBS)

The quality indicators (QIs) reflect the health and well-being of beneficiaries receiving home and community-based services (HCBS) through state Medicaid programs. The indicators focus on the well-being of HCBS beneficiaries as reflected by potentially preventable hospitalizations. These include hospitalizations for specific conditions associated with chronic disease exacerbation and progression as well as poor access to care and support services. The HCBS Population Technical Report provides background on the HCBS QI development as well as the results of the HCBS literature review, discussions with HCBS population experts, and empirical analyses. For additional information on the development of the HCBS QIs, view the resources below:

  • Literature Review — Provides guidance for using the AHRQ QI for public reporting and payment initiatives; includes analysis of each indicator to determine their appropriateness for use in comparative reporting and comparative reporting templates based on input from consumers, providers, experts in the field of public reporting, and others.

  • Expert Panels — Summarizes HCBS panel comments on the validity of the HCBS indictors as a set, factors that panelists believe might impact hospitalizations for the indicator conditions or events in the HCBS populations and panelists' comments and concerns about each indicator.