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Public Reporting of Quality Information on Medicaid Health Plans

While Medicaid expenditures have grown significantly, many U.S. states do not offer detailed information resources showing the quality of care achieved for Medicaid beneficiaries. States report health care quality for Medicaid managed health care plans on a voluntary basis, and organizations such as Mathematica Policy Research have called for more transparency.

  1. Reporting

    • In general, information on the effectiveness of health care outcomes and services for people covered under Medicaid, was found to be lacking in a 2007 analysis by Mathematica Policy Research. Twenty one states reported data under the Health Care Effectiveness Data and Information Set (HEDIS), which is a measure used by many health plans to assess the performance of the overall delivery of health care. However, the research group found the data to be "sometimes thin."

    Considerations

    • In Illinois, Medicaid spending represented 30 percent of the state's total budget as of 2010, yet the Illinois Policy Institute found that the state lacked sufficient publicly-available data showing the effectiveness of health care delivered to people covered under Medicaid health plans.

    Importance

    • Public reporting of Medicaid health care quality is seen as a key aspect of making the system of health care delivery more cost effective. The U.S. Department of Health and Human Services projected that Medicaid spending nationwide would reach $674 billion by 2017, outpacing the growth in the economy.

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