MEDICAID SCORECARD INTRODUCED BY CMS TO ASSESS PROGRAM'S ADMINISTRATION

The Center for Medicare and Medicaid Services recently released a Medicaid Scorecard to improve transparency and accountability. The scorecard contains care quality data from 2015 statistics provided by participating states, in addition to federally reported information. By combining this data, CMS and the states look to evaluate the performance of Medicaid plans, the program's administration, and outcomes. Any effort to improve efficiencies within the Medicaid program is met with unanimous support across the country; however, industry experts are concerned with the quality of the data used and the underlying purpose of the Medicaid Scorecard.

CMS's preliminary Medicaid scorecard intends to improve state and federal alignment, beneficiary health outcomes, and program administration. It functions to analyze how effectively states are delivering health services to their beneficiaries; at the same time, it takes a look at the timespan it takes for the federal government to authorize waiver requests from the states. The Medicaid Scorecard focuses on three particular 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 accessibility to Medicaid data and the program's care outcomes. Verma declared, "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 call into question the quality of the data and what conclusions can be made from it. In their point of view, the data itself is out of date, rendering it an unreliable source to identify a state's performance. Additionally, they point out that any determinations made from the scorecard will be problematic since 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 groups CEO, Margaret Murray, sees CMS's initiative as a good start. Murray shared, "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 issued their Medicaid Scorecard with hopes to improve state and federal alignment, beneficiary health outcomes, and program administration; however, Industry experts are calling into question its methodology.

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