State Lags in Reporting Medicaid Data

Gov. Scott Walker. Photo from the State of Wisconsin.

Last week was Sunshine Week, the annual nationwide celebration of access to public information. Now that the celebrating is over, perhaps it’s a good time to bring up an area where Wisconsin needs to let in considerably more sunshine – health care quality measures for children served by Medicaid and the Children’s Health Insurance Program (CHIP).  Federal law encourages voluntary reporting of those measures, but Wisconsin is lagging well behind most other states in reporting that information.

At a time when there are so many divisive political issues and vitriolic debates, Sunshine Week provides some welcome respite because politicians across the political spectrum generally agree that government should be open and accessible. The bipartisan support for open government has been evident this week in press releases from Governor Scott Walker and other politicians. The Governor also issued an executive order that establishes new requirements for state agencies relating to open records requests and requires each major state agency to report publicly on its performance on a new “performance dashboard” website.

We were heartened that the Governor’s press releases this week go beyond the matter of open records requests and include an emphasis on sharing agency performance measures. You can’t improve what you don’t measure, and you’re less likely to improve on measures that aren’t shared – which is why we would like the Dept. of Health Services (DHS) to report how the state is doing with respect to children’s health care quality measures.

The 2009 CHIP Reauthorization Act, which was approved with broad bipartisan support, directed federal officials to develop a set of Children’s Health Care Quality Measures for Medicaid and CHIP. The primary set of measures (referred to as the Child Core Set) was first published in 2011, and the measures have been updated each year. They include measures related to:

• Primary Care Access and Preventive Care,
• Care of Acute and Chronic Conditions,
• Perinatal Health,
• Behavioral Health,
• Experience of Care, and
• Dental and Oral Health Services.

The 2015 Annual Report on the Quality of Care for Children in Medicaid and CHIP, which was issued just a few weeks ago, shows that Wisconsin continues to lag far behind most other states in reporting on the pediatric health care quality measures.  There are 23 measures in that report, which is based on the 2014 Child Core Set, and Wisconsin reported on only four of those (though that is up from just two the previous year).  Yet 41 states reported on at least half of the measures in the Child Core Set, and two states, Georgia and South Carolina, reported on all of the measures for 2014.

Medicaid and CHIP services, which are delivered in our state via BadgerCare, are extremely important for more than 450,000 Wisconsin children. It’s very important for those children and for Wisconsin taxpayers that we measure and report on the quality and effectiveness of the investments we are making in BadgerCare. Using the national quality standards is a way to monitor performance within our state and to compare that performance with other states.

The Governor’s initiative to enhance agency reporting of performance measures was a welcome development. A great way for DHS to embrace that initiative is for them to begin reporting on all or most of the national quality measures for children in Medicaid and CHIP.

Jon Peacock and Sashi Gregory