Beginning in fiscal year (FY) 2024, states will be required to report on the core sets of children’s health care quality measures in Medicaid and the State Children’s Health Insurance Program (CHIP) and adult behavioral health measures in Medicaid.
This presentation reviews the draft chapter on state readiness to report mandatory core set measures, which will be included in MACPAC’s March 2020 Report to Congress on Medicaid and CHIP. The chapter includes an overview of the child and adult core sets, including the initial development, selection, and maintenance of measures; funding, technical assistance, and other resources that the Centers for Medicare & Medicaid Services has provided to states to assist with reporting; the current state of child and adult core set reporting; and challenges in reporting related to administrative capacity and the availability and timeliness of data. The chapter does not include recommendations.
The chapter discusses numerous technical challenges that state Medicaid programs will need to address, such as accessing data from medical records or other state agencies; obtaining data for certain populations to ensure complete reporting; and having sufficient administrative capacity to collect and analyze data. The chapter concludes that states need timely guidance from CMS on the core set reporting requirements and additional technical assistance to ensure readiness for mandatory reporting in FY 2024.