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Final rule requires national reporting of standardized Medicaid and CHIP quality measures to improve quality and advance health equity

Today, the Centers for Medicare & Medicaid Services (CMS) released a final rule to require reporting of standardized quality measures in Medicaid and the Childrens Health Insurance Program (CHIP). The data on these quality measures will help CMS identify opportunities to improve the provision of high-quality, person-centered health care and reduce health disparities among the millions of people enrolled in Medicaid and CHIP.

This rule finalizes requirements for mandatory annual state reporting of three different quality measure sets starting in federal fiscal year 2024:

• Core Set of Childrens Health Care Quality Measures for Medicaid and CHIP;
• Behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid; and
• Core Sets of Health Home Quality Measures for Medicaid.

The purpose of the Child and Adult Core Sets is to measure the overall national quality of care for beneficiaries, monitor performance at the state level, and improve the quality of health care. The purpose of the Health Home Core Sets is to measure the overall national quality of health home care for Medicaid beneficiaries, monitor the impact of this optional state plan benefit, monitor performance of this benefit at the state and program levels, and improve the quality of health care. States will be required to report stratified data for an increasing number of measures over time, with potential stratification factors including geography and race/ethnicity.

For more information, or to review the rule in its entirety, visit the Federal Register.

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