CMS Introduces CHIP “Scorecard” as Transparency Measure

 Questions still linger regarding specifics of implementation.

The Centers for Medicare & Medicaid Services (CMS) has unveiled a new Medicaid and Children’s Health Insurance Program (CHIP) “Scorecard,” described by the federal agency as “a central component of the Administration’s commitment to modernize the Medicaid and CHIP program through greater transparency and accountability for the program’s outcomes.”

The introduction marks the first time CMS has published state Medicaid and CHIP quality metrics, along with federally reported measures, in such a format.

“Despite providing health coverage to more than 75 million Americans at a taxpayer cost of more than $558 billion a year, we have lacked transparency in the performance and outcomes of this critical program,” CMS Administrator Seema Verma said in a press release issued earlier this week. “The Scorecard will be used to track and display progress being made throughout and across the Medicaid and CHIP programs, so others can learn from the successes of high-performing states. By using meaningful data and fostering transparency, we will see the development of best practices that lead to positive health outcomes for our most vulnerable populations.”

The Scorecard reportedly includes measures voluntarily reported by states, as well as federally reported measures in three areas: state health system performance, state administrative accountability, and federal administrative accountability. These metrics reflect data on matters such as well child visits, mental health conditions, children’s preventive dental services, and other chronic health conditions, CMS said.

The Scorecard is a key component of what CMS described as Verma’s “new vision” for Medicaid and CHIP that was announced during the NAMD conference in November 2017.

“Our vision for the future of Medicaid is to reset the federal-state relationship and restore the partnership, while at the same time modernizing the program to deliver better outcomes for the people we serve,” Verma said. “We need to ensure that we are building a Medicaid program that is sound and sustainable to help all beneficiaries reach their highest potential.”

In its press release, in addition to the Scorecard, the agency touted updates to its Medicaid 1115 demonstration website, new guidance to “offer states more flexibility to address the opioid crisis” through Medicaid, and a new opportunity for states to test community engagement incentives to help lift adult Medicaid beneficiaries from poverty as some of its more recent initiatives designed to improve healthcare nationwide.  

“As CMS continues to approve groundbreaking Medicaid demonstrations, the agency has maintained a focus on enhancing our evaluation of state health system performance and outcomes,” the release read. “In addition to ensuring robust evaluations of demonstration projects, CMS will also continue to emphasize the importance of measuring a broad set of health outcome metrics across states. Given its important role in covering over 35 million children across the country, paying for approximately 50 percent of the country’s births, and as the single greatest payer for long-term care services for the elderly and people with disabilities, public reporting of core quality metrics maintains an important responsibility of states and the federal government.”

In future years, CMS added, the CHIP Scorecard will be updated annually with new functionality and new metrics, including opioid-related and home and community-based services-related quality metrics, as well as the ability to compare spending patterns.

“CMS will (also) continue to work with states to encourage greater reporting across a broader set of metrics to improve consistency across states,” the agency noted. “Through a strengthened partnership with states, CMS will advance policies and projects that increase flexibility, improve accountability, and enhance program integrity, and are designed to fulfill the Medicaid program’s promise to help Americans lead healthier, more fulfilling lives.”

The Scorecard can be viewed online at https://www.medicaid.gov/state-overviews/scorecard/index.html. For more information, a fact sheet has also been posted to the federal Medicaid website at https://www.medicaid.gov/state-overviews/downloads/scorecard/factsheet.pdf.

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