2017 Child Core Set of Health Care Quality Indicators in Medicaid and CHIP Released

The results of state reporting on the 2017 Child Core Set of Health Care Quality Measures in Medicaid and CHIP have been released by CMS. The 2017 Child Core Set includes 27 measures that assess key aspects of health care access for children and pregnant women. While reporting on last year’s core set seems timely, it’s important to remember that the data reflects 2016 health care services provided to children enrolled in Medicaid and CHIP.

Reporting on the core set is voluntary as reflected in the number of measures reported by states, ranging from a low of only one measure reported by North Dakota to a high of 25 measures reported by South Carolina. While the median number of reported measures remained at 18, there were 21 states that reported more measures than in the prior year. Although CMS provides a complete list of measures reported by each state, it only releases state level data on a measure if at least 25 states report it. Twenty measures made the cut with nearly all states reporting on key preventive measures including well child checkups, dental checkups and access to primary care providers. The topline results can be found in this factsheet with a summary of state-level performance, including maps that reflect comparative state rankings in quartiles, in this helpful chartpack.

Highest performance across the states is found on access to primary care practitioners and timeliness of prenatal care, where the median state rate was above 75 percent. On the other hand, median performance was below 50 percent on preventive dental services and dental sealants, medication management for children with asthma, follow-up within seven days after hospitalization for a mental illness, and the development screening measure. (Stay tuned for a deeper dive blog on the developmental screening measure by my colleague Elisabeth Burak.) State performance also fell below the 50 percent rate on three indicators of adolescent health: well-care visits, HPV vaccinations, and chlamydia screening.

Six measures did not make the minimum number of states reporting threshold included two new measures in the 2017 child core set: use of first-line psychosocial care for children and adolescents on antipsychotics, and postpartum contraceptive care. The other measures with insufficient reporting were cesarean section, behavioral risk assessment for pregnant women, audiological evaluation by 3 months of age, and children and adolescent major depressive disorder/suicide risk.

While reporting on the child core set is currently voluntary, mandatory reporting will take effect in 2024 as part of the Access Act included in the Bipartisan Budget Act of 2018. In the coming weeks, we’ll take a closer look at state performance on these key measures.

Tricia Brooks is a Research Professor at the Center for Children and Families (CCF), part of the McCourt School of Public Policy at Georgetown University.