Beginning in fiscal year 2024, states will be required to report on the core sets of children’s health care quality measures and adult behavioral health measures in Medicaid and the State Children’s Health Insurance Program (CHIP). MACPAC contracted with Mathematica to examine state readiness and factors to facilitate mandatory reporting.
In interviews with health plans, Centers for Medicare & Medicaid Services (CMS) staff, and seven state Medicaid programs, we learned that states face challenges related to data access and quality, adherence to core set technical specifications, and administrative capacity for reporting. States also reported needing CMS guidance on what measures will be included in the mandatory core set and an implementation timetable that provides states sufficient time to plan and implement changes needed to fully prepare for mandatory reporting. They cited the need for technical assistance and resources to support these efforts.
CMS has taken some initial steps to consider how to implement the reporting mandate but has not yet issued formal guidance. This presentation provides background on core set measures and the key findings from interviews.