- CMS has released a scorecard for Medicaid and the Children's Health Insurance Program that it hopes will create transparency and accountability for the programs' outcomes. The scorecard allows the public to analyze voluntarily-reported state Medicaid and CHIP quality metrics as well as federally reported measures.
- CMS Administrator Seema Verma said the agency is planning on improving the functionality of the scorecard, adding new measures on cost, allowing for year-to-year comparisons and implementing tools to help the public better understand the differences in performance from state to state.
- The National Association of Medicaid Directors said they hope future versions of the scorecard are improved. In a letter, the directors said they are concerned about the "comparability, accuracy and timeliness of the data" and said differences in care delivery approaches from state to state that might be lost in translation.
The scorecard aligns with CMS' stated goal of avoiding micromanaging state Medicaid programs and instead holding states accountable for outcomes. It's also the latest push from the agency in a string of moves to increase transparency and accountability for public healthcare programs, following an initiative announced earlier this spring that strives to make CMS Medicare Advantage data more accessible and usable for researchers.
The announcement, however, was met with some skepticism of the value added, particularly because of the voluntary nature of much of the state data submission. To that end, the NAMD asked CMS to use "accurate and comparable" data sets and include "meaningful context" for the data included in the scorecard.
The launch of the scorecard shines a light on how Medicaid and CHIP funds are being spent. In 2016, Medicaid spending grew 3.9% to $565.5 billion, accounting for 17% of total national health expenditures, according to CMS. A number of states are still debating whether to expand Medicaid under the Affordable Care Act. According to the Medicaid and CHIP Payment and Access Commission, CHIP spending reached about $13.6 billion in 2016.
This tool gives the public a way to see how those dollars are being spent while raising the bar for state performance.
By tracking and displaying progress on outcomes, "others can learn from the successes of high-performing states," Verma said in a statement Monday. "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 includes federally reported measures in state health system performance, state administrative accountability and federal administrative accountability. Those federal measures will be displayed alongside measures voluntarily reported by states. Metrics will reflect progress being made on issues such as mental health conditions and child well visits.
"This first release of the Medicaid scorecard is a huge step forward," Verma said during a briefing on the scorecard. "But it's just the first step."
CMS plans on updating the scorecard with additional and more robust data, functionalities and metrics, including "opioid-related and home and community based services-related quality metrics" and the ability to compare spending patterns, according to a release.