CMS' Scorecard Measures Medicaid and CHIP Performance at Federal and State Levels

The Centers for Medicare and Medicaid Services (CMS) released an updated dashboard evaluating federal and state performance and administration of Medicaid and the Children’s Health Insurance Program (CHIP).

The 2024 Medicaid and CHIP (MAC) Scorecard includes state-by-state information showing that, on average, Medicaid covered the costs of more than 41 percent of all births in 2022. In 2023, nearly 60 percent of children got the recommended number of checkups in their first 15 months, and just over 45 percent of children and adolescents got at least one annual checkup. Almost 43 percent of children had preventive dental visits in 2022.

The MAC Scorecard draws from more than 30 data sets derived from state and federal reporting efforts. Other key findings from the 2024 Scorecard include the following:

• States are increasingly meeting targets for the Outcomes-Based Assessment (OBA), an improved assessment framework to review the quality of state Transformed Medicaid Statistical Information System (T-MSIS) data submissions, which are used for Medicaid and CHIP program performance monitoring and analyzing service payments. Thirty-nine states met OBA targets in April 2024, compared to 35 in April 2023 and 25 in April 2022.
• Both the share of total long-term services and support (LTSS) users that receive care through home- and community-based services (HCBS), and the share of total Medicaid LTSS spending devoted to HCBS, reached all-time highs in 2021 as states continued to focus on serving more people in home and community-based settings and reducing use of institutional services. In 2021, 63.2 percent of Medicaid LTSS expenditures were for HCBS, while 86.2 percent of LTSS users received HCBS. That year, among states that submitted data, Wisconsin had the highest percentage of Medicaid LTSS expenditures for HCBS at 93.5 percent, while Illinois had the lowest at 27.9 percent.

For the first time, the Scorecard, designed by Mathematica, includes a new State Focus feature that enables users to examine performance values for up to three states or territories across all applicable measures in the Scorecard in a single view.

“The 2024 Scorecard builds on earlier versions and includes more robust features to help states measure their performance across the key priorities of CMS,” said Carol Irvin, a senior fellow at Mathematica. “The Scorecard serves as a great example of turning the complexities of Medicaid and CHIP data into a tool that furthers public understanding of these programs and provides critical support to policymakers and program administrators making data-driven decisions.”   

CMS launched the MAC Scorecard in June 2018 to improve the public transparency and accountability of the Medicaid and CHIP programs. Mathematica has managed the content development process since the Scorecard's inception, and in 2023, took over technical development of the Scorecard site.