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July 18, 2019

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CMS Refreshes Medicaid and CHIP Scorecard

Data refresh captures progress in state reporting as Scorecard seeks to improve transparency and accountability regarding health care quality and outcomes

Today, the Centers for Medicare & Medicaid Services (CMS) refreshed data within the Medicaid and Children’s Health Insurance Program (CHIP) Scorecard, which was released for the first time last year. The targeted data refresh, which comes amidst CMS’s ongoing effort to transform Medicaid by promoting accountability and ensuring program integrity for taxpayers, reflects states’ progress in increasing their reporting of patients’ health outcomes, particularly related to behavioral health.

The Scorecard is a central component of the Trump Administration’s commitment to modernizing and strengthening the Medicaid and CHIP programs – programs that provide health coverage to more than 72 million Americans at a cost to taxpayers of over $558 billion a year. The Scorecard allows every American to see how well the Medicaid and CHIP programs are improving the lives of beneficiaries. It also ensures the efficient use of taxpayer dollars so that those who administer state Medicaid and CHIP programs can be held accountable for the program’s performance.

“Everyone – whether you are a beneficiary, taxpayer, or lawmaker – deserves to understand the performance of our nation’s largest health coverage programs and often the largest state expenses,” said CMS Administrator Seema Verma. “More and more states are voluntarily reporting their health outcomes in the Scorecard, and the new data is leading us into an era of increased transparency and accountability, so that together we can improve the quality of care we give to the vulnerable Americans that depend on this vital program.”

The Scorecard also falls in line with President Trump’s commitment to “cut the red tape” by aligning existing reporting requirements with these other data sets and incorporating new data over time. It includes measures voluntarily reported by states, as well as federally reported measures, in three portions: state health system performance; state administrative accountability; and federal administrative accountability. The publication of the first Scorecard in June 2018 generated a new level of interest in state Medicaid quality measures. Since that time, state Medicaid directors focused on increasing their own reporting and, given the progress states have made, CMS is refreshing data from the 2018 Scorecard to capture new data from more states submitting their outcomes.

Highlights from today’s data refresh include:

Fifty three new data points were reported by states across the 12 measures within the state health system performance portion, including measures on postpartum care; well child visits; potentially avoidable hospitalizations for diabetes among adults; and follow-up after hospitalization for mental health among adults.
For eight of the measures within the state health system performance portion, three to seven additional states reported each measure.
Seven additional states reported on how well they are doing on follow-ups after hospitalization for mental illness among adults.
Five additional states reported on their performance on the use of concurrent antipsychotics among children and adolescents

As part of CMS’s overall commitment to robust public reporting of quality and administrative metrics that drive performance improvement, the agency is also working to enhance the functionality of the Scorecard as part of a comprehensive annual update expected to be published later this fall. The updated Scorecard will have improvements in both the measure set and in website functionality. CMS has engaged with a broad set of internal and external stakeholders to finalize the updates to the fall Scorecard measure set and to encourage greater reporting across a broader set of metrics to improve consistency across states. As states continue to seek greater flexibility from CMS, the Scorecard serves as an important tool to ensure that CMS collects and reports on critical outcome metrics.

In addition to bringing greater transparency to Medicaid outcomes, CMS will continue to create an environment of shared learning and opportunity through a strong state and federal partnership to ensure best practices, which will lead to positive health outcomes for our most vulnerable populations.

The Scorecard can be found here: https://www.medicaid.gov/state-overviews/scorecard/index.html