Ensuring Medicaid and CHIP Quality

In recent years, many changes have occurred in state and federal policies with respect to Medicaid quality requirements, measures, and improvement initiatives. During this presentation, staff provided a refresher on key Medicaid and the State Children’s Health Insurance Program (CHIP) managed care quality requirements, as well as quality improvement and measurement activities conducted by states, plans, and the Centers for Medicare & Medicaid Services. Staff also provided a summary of preliminary findings on state performance over time on selected core set measures and managed care plan performance on performance improvement projects, which suggest the effectiveness of these efforts is unclear. Staff identified potential areas for future MACPAC work related to quality of care in Medicaid and CHIP.