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Children's Health Care Quality Measures

Core Set of Children's Health Care Quality Measures

The Child Core Set is updated annually, in compliance with section 1139A of the Social Security Act. The Core Set Annual Review Workgroup reviews the Child Core Set and identifies ways to improve it, using the annual review and selection process. A draft report from the workgroup meeting is made available for public comment. A final report, including the workgroup recommendations and public comments is then provided to CMS. CMS issues an annual update to the Child Core Set based on the workgroup recommendations. The Core Set History table and Historical Policy Guidance documents provide a history of the updates to the measures included in the Child and Adult Core Sets.

Reporting on the Child Core Set became mandatory for states in 2024. CMS’ August 2023, final rule outlines the requirements for annual mandatory reporting. Annual state reporting of the Core Set typically takes place in the Fall. CMS releases data for Core Set measures that are reported by at least 25 states and meet CMS standards for data quality.

2026 Child Core Set

The 2026 Child and Adult Core Sets were released in a December 2024 State Health Official (SHO) Letter. Reporting on the 2026 Child Core Set, for services primarily provided during 2025, will take place in Fall 2026.

The Annual Workgroup for the 2026 Core Sets took place in February 2024. The recommendations and public comments are found in the 2026 Final Report.

2025 Child Core Set

The 2025 Child and Adult Core Sets were released in a May 2024 State Health Official Letter, which also provided details on mandatory reporting. Reporting on the 2025 Child Core Set will occur in Fall 2025. 

The Annual Workgroup for the 2025 Core Sets took place in April 2023. The recommendations and, public comments are found in the 2025 Final Report.

2024 Child Core Set

The 2024 Child and Adult Core Sets were released in a November 2022 CMCS Informational Bulletin (CIB). Reporting on the 2024 Child Core Set, for services primarily provided during 2023, took place in Fall 2024.

The Annual Workgroup for the 2024 Core Sets took place in April 2022. The recommendations and public comments are found in the 2023 and 2024 Final Report.

Child Core Set Data – Reflecting Quality of Care for Children in Medicaid and CHIP

CMS annually releases information on Child Core Set measures that are reported by at least 25 states and met CMS standards for data quality. The Core Set year represents the year that data is reported to CMS, the data generally represents care delivered the prior year. Information about performance on frequently-reported health care quality measures in the Child Core Set is provided below and on the Core Set Data Dashboard, in addition state-specific quality information can also be viewed in the Quality of Care section of the State Medicaid & CHIP Profiles web page.

Related Initiatives

Other Children’s Quality Measures Initiatives

CMS also has other initiatives that relate to children’s quality measures, including a Pediatric Quality Measures Program (PQMP) and the Pediatric Electronic Health Record Format. Quality measures are used to evaluate or quantify specific health care processes, outcomes, patient perceptions, or other factors related to health care delivery. The pediatric quality measures are used by state Medicaid and Children’s Health Insurance Programs (CHIP) and other public and private programs, providers, plans, patients, and their families to measure and improve the quality of children’s health care. On October 3, 2016, the Agency for Healthcare Research and Quality (AHRQ) and CMS announced awards totaling $13.4 million in funding over four years to six new PQMP grantees focused on implementing new pediatric quality measures developed by the PQMP Centers of Excellence (COE).

Children's Electronic Health Record Format

The AHRQ/CMS-sponsored work to develop the Children's Electronic Health Record (EHR) Format began in 2009 and culminated in the 2013 public release of the format. In 2010, CMS issued quality demonstration grants to 18 states. Two of these states, North Carolina and Pennsylvania, completed demonstration projects to provide CMS with information on the use and impact of standard EHR components for children. These grantee experiences informed the development of the 2015 Priority List.  It is hoped the adaptation of EHRs to meet the 2015 Priority List requirements will lead to safer medication use, better tracking and completion of childhood immunizations, improved communication and knowledge about growth and development, better screening and management of children with special health care needs, and a variety of other specific benefits. An explicit goal of this work is to draw vendor, provider, and stakeholder attention to the needs of children, which are often de-prioritized given a limited IT marketplace for pediatric products and a large number of meaningful use EHR certification requirements that consume vendor and practice resources.

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