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CMCS Updates New Core Quality Measures for Medicaid, CHIP

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Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

CMCS Updates New Core Quality Measures for Medicaid, CHIP

December 30, 2015 | Children and Youth | Medicaid | Comments
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Earlier this month, the Center for Medicaid and Children’s Health Insurance Program Services (CMCS) published an update to core quality measures for adults and children enrolled in Medicaid and CHIP. The core measures are tools states can use to monitor and improve the quality of services provided to the Medicaid and CHIP population. The new measures will take effect no later than December, 2016.

In 2011, CMCS created two core sets of measures to monitor the quality of services in Medicaid and CHIP: the Child Core Set and the Adult Core Set. The goal of these core sets is to encourage national reporting by states on a uniform set of measures and support states in using these measures to drive quality improvement. Of particular importance to behavioral health stakeholders, is the addition of new opioid-related measures for 2016.

To the Child Core Set, CMCS will begin tracking the use of multiple concurrent antipsychotics in children and adolescents. To the Adult Core Set, CMCS will begin monitoring the use of opioids from multiple providers at high dosage in patients without cancer as well as monitoring diabetes screenings for individuals with schizophrenia or bipolar disorder who are using antipsychotic medications.

To aid states in implementing these changes, CMCS will be releasing technical supporting documents in the spring. The National Council will share these documents when they become available. For more information on CMCS reporting requirements, click here.

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