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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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First Annual Reporting on the Quality of Care for Children in Medicaid and CHIP
Policy Guidance - Summarizes State-specific and national information on the quality of health care furnished to children under titles XIX (Medicaid) and XXI (CHIP) of the Act. It also provides information on current State reporting of quality measures, Well-Child Visits in the First 15 Months of Life (W15-CH), Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (W34-CH).
Search Terms
Experience of Care, Primary Care Access and Preventative Care, Well-Child Visits, Dental and Oral Health Services, Asthma And/or COPD
Findings from the 2019-2020 EQR technical reports
Data and Statistics, State experiences - Includes EQR tables, graphs, and reports describing performance measures and PIPs for Medicaid managed care plans regarding care provided to children and pregnant women, by state, 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), Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication (ADD-CH), Screening for Depression and Follow-Up Plan: Age 18 and Older (CDF-AD), Screening for Depression and Follow-Up Plan: Ages 12 to 17(CDF-CH), Follow-Up After Hospitalization for Mental Illness: Ages 6–17 (FUH-CH), 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), Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-CH)*, Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP-CH), 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), Ambulatory Care: Emergency Department (ED) Visits (AMB-CH), 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 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), Asthma Medication Ratio: Ages 19–64 (AMR-AD), Dental Sealants for 6–9 Year-Old Children at Elevated Caries Risk (SEAL-CH), Percentage of Eligibles Who Received Preventive Dental Services (PDENT-CH), Experience of Care Core Set Measures , Long Term Services & Supports Core Set Measure , PC-01: Elective Delivery (PC01-AD), PC-02: Cesarean Birth (PC02-CH), Audiological Diagnosis No Later Than 3 Months of Age (AUD-CH), Live Births Weighing Less Than 2,500 Grams (LBW-CH), Prenatal and Postpartum Care: Timeliness of Prenatal Care (PPC-CH), Prenatal and Postpartum Care: Postpartum Care (PPC-AD), Contraceptive Care – Postpartum Women Ages 15–20 (CCP-CH), Contraceptive Care – Postpartum Women Ages 21–44 (CCP-AD), Contraceptive Care – All Women Ages 15–20 (CCW-CH),Asthma Medication Ratio: Ages 5–18 (AMR-CH), Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC-CH), Chlamydia Screening in Women Ages 16–20 (CHL-CH), Childhood Immunization Status (CIS-CH), Screening for Depression and Follow-Up Plan: Ages 12–17 (CDF-CH), Well-Child Visits in the First 15 Months of Life (W15-CH), Immunizations for Adolescents (IMA-CH), Developmental Screening in the First Three Years of Life (DEV-CH), Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (W34-CH), Adolescent Well-Care Visits (AWC-CH), Cervical Cancer Screening (CCS-AD), Chlamydia Screening in Women Ages 21–24 (CHL-AD), Flu Vaccinations for Adults Ages 18 to 64 (FVA-AD), Screening for Depression and Follow-Up Plan: Age 18 and Older (CDF-AD), Breast Cancer Screening (BCS-AD), Adult Body Mass Index Assessment (ABA-AD).
Search Terms
Maternal and Perinatal Health, Birth Outcomes, Contraceptive Care, Delivery Outcomes, Postpartum Care, Prenatal Care, Long Term Services and Supports, Experience of Care, Primary Care Access and Preventative Care, Adult Screenings, Childhood Screenings, Immunizations, STI Screening, Weight Assessment and Counseling, Well-Child Visits, Dental and Oral Health Services, Behavioral Health, Antipsychotic Drugs, Care of Transitions and Follow-Up, Medication Management, Multiple Complex Conditions, Opioids, Screenings and Follow-Up, Substance Abuse or Dependence Treatment, Tobacco Use Treatment, Care of Acute and Chronic Conditions, Ambulatory Care, Asthma And/or COPD, Cardiovascular Disease, Diabetes, HIV Care, Hospitalizations and Readmissions
Findings from EQR Reports Submitted During the 2012-2013 Reporting Cycle 
Data and Statistics, State experiences - Includes EQR tables, graphs, and reports describing performance measures and PIPs for Medicaid managed care plans regarding care provided to children and pregnant women, by state, Asthma Medication Ratio: Ages 5–18 (AMR-CH), PQI 15: Asthma in Younger Adults Admission Rate (PQI15-AD), HIV Viral Load Suppression (HVL-AD), Dental Sealants for 6–9 Year-Old Children at Elevated Caries Risk (SEAL-CH), Percentage of Eligibles Who Received Preventive Dental Services (PDENT-CH), Experience of Care Core Set Measures, PC-01: Elective Delivery (PC01-AD), PC-02: Cesarean Birth (PC02-CH),Live Births Weighing Less Than 2,500 Grams (LBW-CH), Prenatal and Postpartum Care: Postpartum Care (PPC-AD), Asthma Medication Ratio: Ages 5–18 (AMR-CH), Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC-CH), Chlamydia Screening in Women Ages 16–20 (CHL-CH), Childhood Immunization Status (CIS-CH), Screening for Depression and Follow-Up Plan: Ages 12–17 (CDF-CH), Well-Child Visits in the First 15 Months of Life (W15-CH), Immunizations for Adolescents (IMA-CH), Developmental Screening in the First Three Years of Life (DEV-CH), Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (W34-CH), Adolescent Well-Care Visits (AWC-CH), Chlamydia Screening in Women Ages 21–24 (CHL-AD), Flu Vaccinations for Adults Ages 18 to 64 (FVA-AD), Screening for Depression and Follow-Up Plan: Age 18 and Older (CDF-AD).
Search Terms
Maternal and Perinatal Health, Birth Outcomes, Contraceptive Care, Delivery Outcomes, Postpartum Care, Prenatal Care, Experience of Care, Primary Care Access and Preventative Care, Adult Screenings, Childhood Screenings, Immunizations, STI Screening, Weight Assessment and Counseling, Well-Child Visits, Dental and Oral Health Services, Behavioral Health, Medication Management, Multiple Complex Conditions, Opioids, Screenings and Follow-Up, Substance Abuse or Dependence Treatment, Tobacco Use Treatment, Ambulatory Care, Asthma And/or COPD, Diabetes, HIV Care, Hospitalizations and Readmissions
Findings from 2018-2019 EQR Technical Reports
Data and Statistics, State experiences - Includes EQR tables, graphs, and reports describing performance measures and PIPs for Medicaid managed care plans, by state,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), Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication (ADD-CH), Screening for Depression and Follow-Up Plan: Age 18 and Older (CDF-AD), Screening for Depression and Follow-Up Plan: Ages 12 to 17(CDF-CH), Follow-Up After Hospitalization for Mental Illness: Ages 6–17 (FUH-CH), 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), Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-CH)*, Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP-CH), 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), Ambulatory Care: Emergency Department (ED) Visits (AMB-CH), 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 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), Asthma Medication Ratio: Ages 19–64 (AMR-AD), Dental Sealants for 6–9 Year-Old Children at Elevated Caries Risk (SEAL-CH), Percentage of Eligibles Who Received Preventive Dental Services (PDENT-CH), Experience of Care Core Set Measures , Long Term Services & Supports Core Set Measure , PC-01: Elective Delivery (PC01-AD), PC-02: Cesarean Birth (PC02-CH), Audiological Diagnosis No Later Than 3 Months of Age (AUD-CH), Live Births Weighing Less Than 2,500 Grams (LBW-CH), Prenatal and Postpartum Care: Timeliness of Prenatal Care (PPC-CH), Prenatal and Postpartum Care: Postpartum Care (PPC-AD), Contraceptive Care – Postpartum Women Ages 15–20 (CCP-CH), Contraceptive Care – Postpartum Women Ages 21–44 (CCP-AD), Contraceptive Care – All Women Ages 15–20 (CCW-CH),Asthma Medication Ratio: Ages 5–18 (AMR-CH), Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC-CH), Chlamydia Screening in Women Ages 16–20 (CHL-CH), Childhood Immunization Status (CIS-CH), Screening for Depression and Follow-Up Plan: Ages 12–17 (CDF-CH), Well-Child Visits in the First 15 Months of Life (W15-CH), Immunizations for Adolescents (IMA-CH), Developmental Screening in the First Three Years of Life (DEV-CH), Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (W34-CH), Adolescent Well-Care Visits (AWC-CH), Cervical Cancer Screening (CCS-AD), Chlamydia Screening in Women Ages 21–24 (CHL-AD), Flu Vaccinations for Adults Ages 18 to 64 (FVA-AD), Screening for Depression and Follow-Up Plan: Age 18 and Older (CDF-AD), Breast Cancer Screening (BCS-AD), Adult Body Mass Index Assessment (ABA-AD).
Search Terms
Maternal and Perinatal Health, Birth Outcomes, Contraceptive Care, Delivery Outcomes, Postpartum Care, Prenatal Care, Experience of Care, Primary Care Access and Preventative Care, Adult Screenings, Childhood Screenings, Immunizations, STI Screening, Weight Assessment and Counseling, Well-Child Visits, Dental and Oral Health Services, Behavioral Health, Antipsychotic Drugs, Care of Transitions and Follow-Up, Medication Management, Multiple Complex Conditions, Opioids, Screenings and Follow-Up, Substance Abuse or Dependence Treatment, Tobacco Use Treatment, Care of Acute and Chronic Conditions, Ambulatory Care, Asthma And/or COPD, Cardiovascular Disease, Diabetes, HIV Care, Hospitalizations and Readmissions
Findings from 2017-2018 EQR Technical Reports
Data and Statistics - Presents summary tables abstracted from EQR technical reports. CMS requires that all states have final EQR technical reports available to CMS and the public by April 30 of each year. CMS reviews these reports and abstracts data related to Performance Measures and PIPs. This data is analyzed and aggregated into summary tables.
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
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