The Centers for Medicare and Medicaid Services (CMS) has released what is being called a “Medicaid & CHIP Scorecard” that attempts to compare the timeliness and quality of medical care of the two programs state by state, but a major problem is that reporting by the states is mostly voluntary.
“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.” said CMS Administrator Seema Verma.
“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 spans several web pages and covers three main areas: State Health System Performance, State Administrative Accountability, and Federal Administrative Accountability. The report is also broken down into 17 comparison categories, but not one category includes results from all 50 states.
As The Washington Post points out, the statistics are also skewed because those states that reported often used different standards. Some states reported only results from patients who are on managed care; other states reported only results from patients on traditional fee-for-service Medicaid.
When asked if CMS would make the reporting mandatory, Verma said: “I think over time we’re going to review that. It’s possible in the future we may change that policy — as we evolve and as we see how things are going, that might be something we would consider.”
What’s in the Scorecard?
According to the website:
Like Medicaid and CHIP beneficiaries, information in the Scorecard spans all life stages. This first version of the Scorecard includes information on selected health and program indicators. It also describes the Medicaid and CHIP programs and how they operate.
The Scorecard will evolve. Future iterations likely will allow year-to-year comparisons to help identify trends. The Scorecard will be flexible—CMS may add new areas of emphasis important to the Medicaid and CHIP programs or replace measures as more outcome-focused ones become available.
CMS worked with a subset of state Medicaid agencies to select measures for this first Scorecard. Many measures in the Scorecard come from public reports. For example, most measures in the State Health System Performance pillar come from the Child and Adult Core Sets. This approach allows CMS to align the Scorecard with existing reporting efforts.