Medicaid & CHIP Scorecard

The Centers for Medicare & Medicaid Services (CMS) developed its Medicaid and Children's Health Insurance Program (CHIP) Scorecard to increase public transparency about the programs’ administration and outcomes. The Scorecard includes measures voluntarily reported by states, as well as federally reported measures in three areas:

State Health System Performance

State Administrative Accountability

Federal Administrative Accountability

States and CMS can use the Scorecard to drive improvements in areas such as:

• State and federal alignment
• Beneficiary health outcomes
• Program administration

A summary of the Scorecard can be found in the Scorecard Fact Sheet.

What’s in the Scorecard?

Like Medicaid and CHIP beneficiaries, information in the Scorecard spans all life stages. This first version of the Scorecard includes information on selected health and program indicators. It also describes the Medicaid and CHIP programs and how they operate.

The Scorecard will evolve. Future iterations likely will allow year-to-year comparisons to help identify trends. The Scorecard will be flexible—CMS may add new areas of emphasis important to the Medicaid and CHIP programs or replace measures as more outcome-focused ones become available.

CMS worked with a subset of state Medicaid agencies to select measures for this first Scorecard. Many measures in the Scorecard come from public reports. For example, most measures in the State Health System Performance pillar come from the Child and Adult Core Sets. This approach allows CMS to align the Scorecard with existing reporting efforts.

Including measures from the Core Sets in the Scorecard builds on states’ investments in collecting and reporting these voluntary measure sets. While there are many reasons some states do not collect or report all Core Set measures, CMS hopes the Scorecard will draw attention to the importance of reporting on these measures. Core Set reporting methods also can vary among states. For example, some states have access to different data on populations covered under fee-for-service as compared to populations covered under managed care. This variation in data availability can impact measure performance. Readers should review the detailed measure notes located after the graph to better understand states’ reported rates.

The Scorecard also sheds light on important questions about the scope of Medicaid and CHIP. The National Context page presents data to answer the questions:

• Who enrolls in Medicaid and CHIP?
• What are annual expenditures for Medicaid and CHIP?
• What data are CMS and states developing to support program improvement?

States establish and administer their own Medicaid and CHIP programs. As a result, the populations and benefits covered by Medicaid and CHIP vary across states. For example, in all states Medicaid provides health care coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities.  In some states Medicaid also covers all low-income adults below a certain income level. This group is sometimes called “expansion adults.” In CHIP, states can choose to set income levels higher than the federal minimum threshold and to cover pregnant women. Federal law also requires states to provide certain mandatory benefits and allows states to cover other optional benefits in Medicaid and CHIP. States deliver Medicaid and CHIP benefits by directly paying providers – called “fee-for-service” payments – or through contracted arrangements with managed care organizations that oversee benefit delivery.

Click on the Policy and Program Topics links below to view Scorecard data.