Medicaid Directors Voice Concerns over CMS 'Beta' Version Scorecard

Using the old axiom, 'If you've seen one Medicaid program, you've seen one Medicaid program,' stakeholders say Scorecard data does not account for state-by-state program variations.  

A key Medicaid stakeholder has raised concerns about what it calls the "beta version" of a new Scorecard for the program that was released this week by the Centers for Medicare & Medicaid Services.

The National Association of Medicaid Directors is questioning the comparability, accuracy and timeliness of the data that is reported on the scorecard, and the conclusions that may be drawn when comparing states with different structures and care delivery approaches.

While the Scorecard has been annotated to reflect some constraints, the measures remain problematic, NAMD said, adding that meaningful context for using the data is needed.

Problems include:

• Most of the data are sourced to 2015;
   
• In some cases, data reflect a state's beneficiaries in fee-for-service or managed care, but not necessarily beneficiaries in both delivery models. This can result in relatively healthy populations being compared to those with disabilities or complex conditions;
   
• Some states reported using a claims-based only methodology while others used a hybrid methodology of claims and medical record review;
   
• Variability in completeness of reporting as Medicaid Adult and Child Core set measures have been voluntary to date.

"Until these fundamental variances are addressed in the Scorecard, it will not be possible to make apples-to-apples comparisons between states," NAMD said.