Medicaid Scorecard Released by CMS to Assess Program’s Administration

Medicaid Scorecard

16 Jun Medicaid Scorecard Released by CMS to Assess Program’s Administration

The Center for Medicare and Medicaid Services recently released a Medicaid Scorecard to promote transparency and accountability. The scorecard consists of care quality data from 2015 statistics provided by participating states, along with federally reported information. By consolidating this data, CMS and the states look to assess the performance of Medicaid plans, the program’s administration, and outcomes. Any measure to improve efficiencies within the Medicaid program is met with unanimous support across the country; however, industry specialists are concerned with the quality of the data used and the underlying intent of the Medicaid Scorecard.

CMS’s preliminary Medicaid scorecard aims to improve state and federal alignment, beneficiary health outcomes, and program administration. It works to assess how effectively states are delivering health services to their beneficiaries; additionally, it examines the timespan it takes for the federal government to approve waiver requests from the states. The Medicaid Scorecard focuses on three separate areas of measurement:

State Health System Performance measures “how states serve Medicaid and CHIP beneficiaries across key domains.”

State Administrative Accountability provides “insight into how states and the federal government work together to administer Medicaid and the Children’s Health Insurance Program (CHIP).”

Federal Administrative Accountability provides “insight into how the federal government and states work together to administer Medicaid and the Children’s Health Insurance Program (CHIP).”

The Chief of CMS, Seema Verma, views the scorecard as a means of improved access to Medicaid data and the program’s care outcomes. Verma stated, “This is about bringing a level of transparency and accountability to the Medicaid program that we have never had before.” Over time, CMS says it will make updates to the Medicaid Scorecard enabling it to address additional issues.

The National Association of Medicaid Directors (NAMD) has raised concerns. According to NAMD, “There are significant methodological issues with the underlying data, including completeness, timeliness, and quality.” They question the quality of the data and what conclusions can be made from it. In their opinion, the data itself is out of date, making it an inaccurate source to determine a state’s performance. Additionally, they point out that any conclusions made from the scorecard will be problematic because it compares states with significantly different Medicaid structures.

The Association for Community Affiliated Plans (ACAP) is encouraged by the introduction of a Medicaid Scorecard but also recognizes inconsistencies. The associations CEO, Margaret Murray, views CMS’s effort as a good start. Murray said, “we agree with Administrator Verma’s note that this is a beginning in terms of how we talk about quality, rather than an endpoint. For one thing, the draft scorecard brings into sharp relief the need for more uniform, consistent data reporting across the Medicaid program.”

CMS has recently released their Medicaid Scorecard with hopes to improve state and federal alignment, beneficiary health outcomes, and program administration; however, Industry specialists are questioning its methodology.