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Medicaid and CHIP Quality Resource Library

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 for our beneficiaries. Type in a key search term to see what resources are available, or use the filters below to search and browse our quality improvement resources by Medicaid and CHIP Core Set domain and other fields.

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Improving the Health of Mothers and Infants in Medicaid and CHIP: Investing in the Future of Our Nation
Fact Sheet or TA Briefs, State experiences, Webinar - Provides overview of the Maternal and Infant Health Initiative, describes focus of increasing postpartum care and use of contraceptives, shares best practices in New York, Illinois, and North Carolina, provides guidance on quality measurement.
2020 Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP (Child Core Set)
Quality Measure Guidance - Presents the 2020 Child Core Set measures and describes the data collection method for each.
Search Terms
Maternal and Perinatal Health, Long Term Services and Supports, Experience of Care, Primary Care Access and Preventative Care, Dental and Oral Health Services, Behavioral Health, Care of Acute and Chronic Conditions
2020 Core Set of Adult Health Care Quality Measures for Medicaid (Adult Core Set)
No Results - Presents the 2020 Adult Core Set measures and data collection methods for each one.
CMS External Quality Review (EQR) Protocols
Fact Sheet or TA Briefs - Presents the new protocol for conducting an External Quality Review to evaluate managed care plans. In 2020, the Centers for Medicare & Medicaid Services (CMS) is exploring new and innovative opportunities to leverage EQR organizations to ensure a more robust approach to optimizing managed care quality oversight. The protocols are one part of this larger strategy, Controlling High Blood Pressure (CBP-AD)
Search Terms
Care of Acute and Chronic Conditions, Cardiovascular Disease
Measurement Period for Denominators and Numerators for the FFY 2020 Adult Core Set Measures
Quality Measure Guidance - Lists the measurement period for denominators and numerators for the FFY 2020 Adult Core Set measures. Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET-AD), Medical Assistance With Smoking and Tobacco Use Cessation (MSC-AD), Antidepressant Medication Management (AMM-AD), Screening for Depression and Follow-Up Plan: Age 18 and Older (CDF-AD), Follow-Up After Hospitalization for Mental Illness: Age 18 and Older (FUH-AD), Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD-AD), Diabetes Care for People with Serious Mental Illness: Hemoglobin A1c (HbA1c) Poor Control (>9.0%) (HPCMI-AD),Use of Opioids at High Dosage in Persons Without Cancer (OHD-AD),Concurrent Use of Opioids and Benzodiazepines (COB-AD),Use of Pharmacotherapy for Opioid Use Disorder (OUD-AD)*, Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA-AD), Follow-Up After Emergency Department Visit for Mental Illness (FUM-AD), Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA-AD), Controlling High Blood Pressure (CBP-AD), Comprehensive Diabetes Care: Hemoglobin A1c (HbA1c) Poor Control (>9.0%) (HPC-AD), PQI 01: Diabetes Short-Term Complications Admission Rate (PQI01-AD), PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate (PQI05-AD), PQI 08: Heart Failure Admission Rate (PQI08-AD), PQI 15: Asthma in Younger Adults Admission Rate (PQI15-AD),Plan All-Cause Readmissions (PCR-AD), Asthma Medication Ratio: Ages 19–64 (AMR-AD), HIV Viral Load Suppression (HVL-AD), PC-01: Elective Delivery (PC01-AD), Prenatal and Postpartum Care: Postpartum Care (PPC-AD), Contraceptive Care – Postpartum Women Ages 21–44 (CCP-AD),
Contraceptive Care – All Women Ages 21–44 (CCW-AD)
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