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CMS Requires States to Report on Quality Measures in Medicaid and CHIP



The Centers for Medicare & Medicaid Services (CMS) has issued a final rule requiring states to report on three quality measures for Medicaid and the Children's Health Insurance Program (CHIP).


The rule, which goes into effect on January 1, 2024, is a significant step forward in improving the quality of care for beneficiaries in these programs.

The three quality measures that states will be required to report on are:

  • The Core Set of Children's Health Care Quality Measures for Medicaid and CHIP

  • The behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid

  • The Core Sets of Health Home Quality Measures for Medicaid

These measures assess various essential aspects of care, such as preventive care, chronic disease management, and mental health services. CMS can track the quality of care delivered to beneficiaries and identify areas needing improvement by requiring states to report on these measures.


The mandatory reporting requirement is part of CMS's broader effort to improve the quality of care in Medicaid and CHIP. In recent years, CMS has also issued rules that require states to develop and implement quality improvement plans and to use payment incentives to reward providers for delivering high-quality care.



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