CMS Launches New System to Measure State Medicaid Performance

Scorecards will initially focus heavily on metrics that states already voluntarily report

CMS Administrator Seema Verma, here at her February 2017 confirmation hearing, says existing data collection and reporting efforts for states “have been inconsistent at best.” (Bill Clark/CQ Roll Call file photo)

Federal health officials on Monday unveiled a new system to measure how effectively states are running their Children’s Health Insurance Program and Medicaid systems.

The scorecards will initially focus heavily on metrics that states already voluntarily report to the Centers for Medicare and Medicaid Services, such as well-child visits and chronic health conditions, CMS Administrator Seema Verma said during a press briefing. While many measures already existed, this marks the first time they are all being compiled together, Verma said.

The system also includes new data on how states and the federal government are performing administratively, such as how quickly CMS is able to process state applications to change their Medicaid programs.

“Our data collection and reporting efforts have been inconsistent at best,” Verma said of the agency’s past performance. “It’s important that we’re also holding ourselves accountable for achieving results.”

Verma also emphasized that the first iteration of the state scorecard system, which launched publicly Monday afternoon, is just a starting point and that more metrics could be added in the future.

For instance, the data might include measures on Medicaid work requirements programs, such as tracking how many people are working, doing job training or going to school. The Trump administration has so far approved work requirements in four states — Arkansas, Kentucky, Indiana and New Hampshire. CMS is already working with states that want to institute such requirements to develop consistent ways of measuring performance, according to Verma.

In the future, the scorecards could be used in other ways, such as evaluating how Medicaid managed care companies are performing, Verma said. The agency also hopes to eventually add measures on cost and beneficiary satisfaction, as well as create future versions of the scorecards that will allow people to create year-to-year comparisons and understand differences among states.

While there are currently no consequences for states that may have a bad scorecard, that could change, Verma said.

Medicaid covers more than 75 million Americans at a cost of nearly $560 billion a year, she pointed out.

There are “a lot of implications in terms of where this data is going to lead us,” Verma said. “We should understand how the dollars are being spent, and what we’re delivering.”

A group representing state Medicaid directors on Monday raised concerns about the comparability, accuracy and timeliness of the data used to produce the scorecards, as well as any comparisons drawn from them since the structure of Medicaid programs varies widely by state.

“There are significant methodological issues with the underlying data, including completeness, timeliness, and quality of the data,” the National Association of Medicaid Directors said in a statement.

The group said it hopes to work with CMS to address concerns and improve ongoing data reporting.

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