The focus on value has created “measurement fatigue” and “outcomes confusion” among managers of health and human service organizations. The problem is straightforward—to pay based on value, you need measures of “performance.” The challenge for most provider organizations is that payers and health plans require reporting on different measures. This is a problem we’ve written about before in Are You Suffering From Measurement Fatigue?; New Measures Hit The Streets; and When It Comes To Performance Measurement, The “Work” Is Never Done.
In an attempt to create a standardized set of measures for states and health plans, the Centers for Medicare & Medicaid Services (CMS) developed the Child and Adult Core Set for state Medicaid programs in 2012—a group of performance measures that can be compared across states. CMS updates the measure set annually, adding and removing measures as needed. The FY 2016 Adult Core Set contained 28 measures across six domains: preventive care, maternal and perinatal health, behavioral health, care of acute and chronic conditions, care coordination, and experience of care.
The data from these measures gives the rare opportunity to compare state Medicaid programs. So, we took the opportunity to review the data and compare state Medicaid programs on behavioral health performance measures. Our summary of the best and worst performing state Medicaid systems is shown in the chart below—and the scores on every measure for each state can be found in our new latest reference guide: State Performance On Adult Medicaid Core Health Care Measures.
Why are these scores meaningful? If you have programs in a state with high scores, you need to be sure that your program measures up to the competition. These are one of the few benchmarks that are publicly available and can be used to compare your organization’s performance to that of the competition. If your organization isn’t in line with your state number, then you should ask the question: how do we improve our organizational performance to meet (and hopefully exceed) the overall state number?
If the states that you operate in are at the bottom of the pack, there are opportunities. Assuming your performance is above the average, contrast your program performance to the state average—and use it to drive business development and referrals. Include your performance measures, in comparison to the statewide average, in public communications, in health plan presentations, and on your website for consumers and referral sources.
If you don’t know how your programs compare to these measures, now is the time to start down the path of performance measurement and metrics-based performance management. The measures in this set are those that are widely accepted or are likely going to become more important in the next couple of years, so one of these measures is a good place to start with initial tracking and management.
To see how your state stacks up, check out our latest reference guide: State Performance On Adult Medicaid Core Health Care Measures. The guide provides median performance on all measures included in the Core set and then provides a deep dive into state performance on behavioral health measures. The deep dive includes individual state performance on each measure and a comparison to 2015 scores where available.
For more on the current state of performance measurement, check out these resources in the OPEN MINDS Industry Library:
- Are You Suffering From Measurement Fatigue?
- A Few More Drops In The Performance Measurement Bucket
- For All The Performance Measurement, Are We Really Measuring Performance?
- When It Comes To Performance Measurement, The “Work” Is Never Done
- Who’s Measuring Performance? An Overview Of The Measures, By Market
- Moving To ‘Healthy Days’ As A Measure Of Success
- The Dominant Performance Standards Of Today – CMS Stars & NCQA HEDIS
- The Five-Step Process To Demonstrate Your “Performance” To Health Plans
- Is One Set Of Performance Measures Possible?
- Make Your Data ‘Count’
And for more on measuring and reporting “value”, join OPEN MINDS Senior Associate Joseph P. Naughton-Travers on October 24 at The 2018 OPEN MINDS Technology & Informatics Institute for his session, “What Do We Mean By “Value”? A Discussion Session On Defining, Measuring & Reporting Value.”