State Performance On Child Medicaid Core Health Care Measures: An OPEN MINDS Reference Guide
The Children’s Health Insurance Program Reauthorization Act of 2009 and the Patient Protection and Affordable Care Act (PPACA) both contained a requirement that the federal Department of Health and Human Services (HHS) develop and publish a set of health care quality measures, referred to as the Child Core Set and Adult Core Set. The core sets are updated annually. Each year, state Medicaid programs have the option to report on these measures.
The FY 2016 Child Core Set contained six domains: preventive care, maternal and perinatal health, behavioral health and substance use, care of acute and chronic conditions, care coordination, and experience of care. The set contained 26 measures that address key aspects of these domains. DHHS added two measures to the Child Core Set in 2016: audiological evaluation no later than three months of age (AUD) and use of multiple concurrent antipsychotics in children and adolescents (APC).
50 states and the District of Columbia voluntarily reported on at least one Child Core Set measure. The one state that did not report was North Dakota. 36 states reported on more measures than they did in 2015, and the median number of measures reported per state was 18. HHS does not set target goals for each measure in the Core Set. Instead the benchmark used to assess the quality of state outcomes is the national median performance.
Within these two sets of quality measures are a subset of measures focused on mental health and addiction, referred to as the Behavioral Health Core Set. State performance on the fiscal year (FY) 2016 Child Core Set and Adult Core Set have recently been released. This report summarizes performance on the measures at the national level and provides a state level look at performance on the Child Behavioral Health Core Set.
For a look at national and state performance on the Adult Core Set see State Performance On Adult Medicaid Core Health Care Measures.