Enhancing oversight and performance in Medicaid and CHIP

Lack of a unified, reliable view of Medicaid and CHIP performance

Medicaid and the Children’s Health Insurance Program (CHIP) provide coverage to nearly 80 million Americans as of November 2025, and yet performance and administrative data have long been fragmented across multiple systems and reports. Policymakers, researchers, and the public had no single, reliable way to see holistically how programs are operating, where performance is improving, and where support is most needed.

To strengthen transparency and accountability, the Centers for Medicare & Medicaid Services (CMS) sought a unified platform that could bring together critical Medicaid and CHIP data—such as enrollment, expenditure, quality-of-care, and administrative performance data—into a single, publicly accessible source.

Developing a trusted, user-friendly platform for Medicaid and CHIP insights

Mathematica partnered with CMS to develop a user-friendly, interactive tool called the Medicaid and CHIP (MAC) Scorecard. This tool paints a comprehensive picture of how CMS and states jointly administer Medicaid and CHIP—programs funded at $977 billion in federal fiscal year 2024—and how their beneficiaries are served.

Our role in managing the Scorecard continues to evolve since its launch in 2018.

• Integrating data to support faster decision making. We gather, validate, and compile data from more than 30 data sets, including the Transformed Medicaid Statistical Information System, CMS-64 expenditure reports, Medicaid and CHIP Core Sets, and publications on Medicaid long-term services and supports. This curation enables users to access comparable, trustworthy information without navigating multiple systems.
• Applying human-centered design to improve usability. Through focus groups, user interviews, and usability testing, Mathematica identifies opportunities to enhance navigation, functionality, and visual presentation with each update of the Scorecard. These insights make the Scorecard easier to explore and more aligned with how policymakers make decisions.
• Collaborating to ensure the tool meets real-world needs. Working closely with CMS and state Medicaid directors, we confirm the Scorecard reflects both federal priorities and state needs. We also made sure it was designed with a flexible infrastructure so its content can evolve to respond to emerging needs.

Turning Medicaid and CHIP performance data into action-ready insights

The MAC Scorecard provides an array of Medicaid and CHIP performance data in one place, making it easier to develop insights about these programs. The tool brings together quality metrics, administrative measures, and federal and state-reported data into a single public resource, enabling states, policymakers, and the public to readily see how programs are performing.

With the Scorecard, states can:

• Benchmark their performance and progress
• Identify opportunities for improvement and spot high performers that might offer lessons for success
• Access clear data visualizations for reports and presentations to leaders, partners, and the public

For example, California has used the Scorecard in state-specific webinars to spotlight the most urgent areas for progress and to convey CMS’s perspective on state performance, helping focus efforts where they matter most. Puerto Rico has used the measure expectations from the Scorecard to identify data quality and reporting issues.

The Scorecard is more than a reporting tool—it’s a way to strengthen nationwide program quality. Comparisons of data across time and between states not only drive transparency but also encourage better data quality and alignment of federal and state priorities. By highlighting areas where states might need support, CMS can provide targeted technical assistance, ensuring that Medicaid and CHIP deliver on their promise for millions of Americans.