U.S. flag

An official website of the United States government

Health Home Quality Reporting

Health Home Quality Measure Reporting and Evaluation Activities

A goal of Medicaid health home programs is to improve health outcomes for beneficiaries with chronic conditions through coordinated care provided by an interdisciplinary team linking primary, behavioral health, and long term services and supports. The Centers for Medicare & Medicaid Services (CMS) established a core set of health home quality measures that states can report through the Quality Measure Reporting (QMR) system according to the schedule below. These quality and utilization measures will be used for ongoing monitoring and evaluation purposes across all state health home programs.

  • For technical assistance related to calculating, reporting, or using the health home quality measures, submit your questions to the TA Mailbox at MACQualityTA@cms.hhs.gov
  • For assistance with using QMR, contact the QMR Helpdesk at MDCT_Helpdesk@cms.hhs.gov.

General Resources for Reporting Health Home Quality Measures

FFY 2022 Health Home Core Set Reporting Resources

State Reporting Starts: Fall 2022

Measure List and Technical Specifications FFY 2022 Health Home Core Set Measure List (PDF, 138.35 KB)
FFY 2022 Health Home Resource Manual and Technical Specifications (PDF, 822.33 KB)
Summary of Updates to the Health Home Core Set Resource Manual and Technical Specifications for FFY 2022 (PDF, 238.81 KB)
Value Set Directories  FFY 2022 Health Home Core Set HEDIS Value Set Directory (ZIP, 2.35 MB)
FFY 2022 Health Home Core Set Non-HEDIS Value Set Directory (ZIP, 150.25 KB)
Additional Technical Assistance Resources Expected Health Home Core Set Reporting Periods, by Effective Date of SPA: FFY 2021 – FFY 2022 (PDF, 395.56 KB) 
FFY 2022 Data Quality Checklist (PDF, 829.22 KB)
FFY 2022 Health Home Measurement Period Table (PDF, 227.23 KB)
Allowance of Telehealth in the 2022 Child, Adult, and Health Home Core Set Measure Specifications (PDF, 438.61 KB)
Calculating the Controlling High Blood Pressure (CBP) Measure in the Adult and Health Home Core Sets (PDF, 332.47 KB)
Calculating the Plan All-Cause Readmissions (PCR) Measure in the Adult and Health Home Core Sets (PDF, 520.94 KB)
Overview of Substance Use Disorder Measures in the 2022 Child, Adult, and Health Home Core Sets (PDF, 427.08 KB) 
Calculating the Admission to an Institution from the Community (AIF-HH) Measure in the 2022 Health Home Core Set (PDF, 519.08 KB)
Guidance for Calculating the Colorectal Cancer Screening Measure in the 2022 Adult and Health Home Core Sets (PDF, 597.37 KB)
Calculating State-Level Rates Using Data from Multiple Reporting Units (PDF, 338.86 KB)

Archived Reporting Resources

Annual Reporting on the Quality of Health Care for Medicaid Health Home Enrollees

Resources from Federal Evaluation Activities

Resources from State Reporting and Evaluation Activities

States have begun to publish findings from their own health home program evaluations. View state findings from their health home program reporting and evaluation activities.

Iowa:

Maine:

Maryland:

Minnesota:

Missouri:

New York: