2021 Core Sets
The Center for Medicaid and CHIP Services (CMCS) partners with states to share best practices and provide technical assistance to improve the quality of care. CMCS’s efforts are guided by the overarching aims of the Centers for Medicare & Medicaid Services (CMS) Quality Strategy : better health, better care, lower cost through improvement. The CMS Quality Strategy is built on the foundation of the CMS Strategy and the HHS National Quality Strategy .Working with states and other partners to eliminate disparities and improve patient safety are key aspects of achieving these aims.
Medicaid and CHIP Beneficiary Profile and Infographic
The Medicaid and CHIP Beneficiary Profile (PDF, 2.13 MB) was developed to provide an overview of the characteristics, health status, access, utilization, expenditures, and experience of care of beneficiaries served by Medicaid and CHIP. Two special populations are profiled in depth: People Dually Eligible for Medicare and Medicaid and Children with Special Health Care Needs.
The Medicaid and CHIP Beneficiaries at a Glance Infographic (PDF, 211.55 KB) includes selected information drawn from the Beneficiary Profile.
The Medicaid and CHIP Beneficiaries with Sickle Cell Disease (SCD) Report (PDF, 1.61 MB) provides national and state-level estimates for SCD among adults and children enrolled in Medicaid and CHIP, who are under age 76, and highlights various demographic, health, and healthcare utilization characteristics. The SCD Report includes national estimates on antibiotic prophylaxis in children with SCD who are enrolled in Medicaid and CHIP.
The Medicaid and CHIP Beneficiaries with Sickle Cell Disease (SCD) Infographic (PDF, 269.72 KB) includes selected information drawn from the SCD Report. The SCD Infographic is the first use of T-MSIS Analytic Files to report on Medicaid and CHIP beneficiaries living with SCD and represents an important advance in our understanding of the national prevalence and impact of SCD on our beneficiaries.
- Child Core Set
- Adult Core Set
- Maternal and Infant Health Data Measurement
- Maternity Core Set (PDF, 166.56 KB)
- Behavioral Health Core Set (PDF, 159.19 KB)
- Behavioral Health Clinics Quality Measures
- Health Home Quality Reporting
- CHIPRA Quality Demonstration Grants
- Adult Medicaid Quality Grants
- Nationwide Adult CAHPS
- CAHPS® Home and Community Based Services Survey
- Form CMS-416 (annual EPSDT report)
- Child Quality Improvement
- Adult Quality Improvement
- Maternal and Infant Health
- Oral Health
- Long Term Services and Supports
- Patient Safety
- Federal Financial Participation for Managed Care External Quality Review (PDF, 279.08 KB)
- The State of Children’s Health Care Quality in Medicaid and CHIP: State Strategies to Promote Reporting and Performance (03/2016) (PDF, 588.66 KB)
- 2015 Secretary's Annual Report on the Quality of Care for Children in Medicaid and CHIP (02/2016) (PDF, 1.33 MB)
- 2015 Secretary's Annual Report on the Quality of Care for Adults in Medicaid (02/2016) (PDF, 1.17 MB)
- Integrating Oral Health into Primary Care: Maine