State-level data-collection systems and associated databases form the basis for calculating indicator scores. The availability of standardized data sources was an important consideration when selecting the indicators. Indicators were selected based on their potential to drive meaningful improvements in quality and on their near-term implementation feasibility.

Pregnancy Risk Assessment Monitoring System (PRAMS)

PRAMS is a surveillance project of the Centers for Disease Control and Prevention (CDC) and state health departments. PRAMS collects ongoing, population-based state-specific data that are available at the state level. The PRAMS questionnaire, which is developed in phases, includes core questions that are asked by all states, standard questions that states can choose to select, and state-developed questions. Each state convenes a PRAMS steering committee that advises PRAMS staff on questionnaire development; question selection; and use, dissemination, and application of findings.

Behavioral Risk Factor Surveillance System (BRFSS)

BRFSS is a system of health-related telephone surveys that collect state data about U.S. residents relating to their health-related risk behaviors, chronic health conditions, and use of preventive services. BRFSS is sponsored by CDC along with other federal agencies. The oral health module is a rotating core that is included in the BRFSS questionnaire in even-number years.

Basic Screening Survey (BSS)

BSS is a tool for oral health surveillance that was developed by the Association of State and Territorial Dental Directors (ASTDD) to help state and local public health agencies monitor the burden of oral disease. These surveys include direct observation of a child’s mouth. ASTDD provides guidance for conducting, analyzing, and reporting BSS data. ASTDD recommends that the BSS be conducted every 5 years.

Medicaid Administrative Claims and Enrollment Data

Administrative enrollment and claims data are used to calculate several of the indicators for children. All states should have claims data for children enrolled in Medicaid and CHIP. Data elements include date of birth, date of service, CDT codes, tooth number, provider taxonomy codes, and provider billed amounts. Access to data may be challenging. Implementing these indicators will require partnering with epidemiologists or data analysts within these programs. Learn more about dental benefits for children in Medicaid. Visit the DQA State Oral Healthcare Quality Dashboard to see reports that reflect analysis of Transformed Medicaid Statistical Information System (T­ MSIS) Analytic Files from the Centers for Medicare & Medicaid Services.