Skip to main content

A New Era of Accountability and Transparency in Medicaid

By: Administrator, Seema Verma, Centers for Medicare & Medicaid Services

In his first 500 days in office, President Donald J. Trump has achieved results both at home and abroad for the American people, working to ensure government is more accountable to the American people. One of the many promises the Trump Administration has made and kept is improving accountability and transparency in Medicaid.

Medicaid provides healthcare for more than 75 million Americans, including many of our most vulnerable citizens, at an annual cost of over $558 billion. It has grown significantly over the years, consuming an every greater share of our public resources – from 10 percent of state budgets in 1985 to nearly 30 percent in 2016. Medicaid should improve the lives of those it serves by delivering high quality health care and services to eligible individuals at a maximum value to American taxpayers. As the administrators of the program, states, along with their local healthcare professionals who care for their neighbors, know best the unique healthcare needs of their community. Our success on delivering on Medicaid’s promise hinges on the critical role they play in managing the precious state and federal resources with which we are entrusted.

That’s why we have committed to resetting the state-federal partnership by ushering in a new era of state flexibility. We’ve approved groundbreaking Medicaid demonstration projections, including reforms to test how Medicaid can be designed to improve health outcomes and lift individuals from poverty by connecting coverage to community engagement. We are streamlining our internal processes and breaking down regulatory barriers that force states to commit too much of their time and resources to administrative tasks rather than focusing on delivering better care.

But with that commitment to flexibility must come an equal pledge to improve transparency and accountability. Too often we have struggled to articulate our collective performance in executing on our immense responsibility. This is best reflected in the fact that Medicaid is responsible for approximately half of the nation’s births, yet no one will argue that we are achieving the birth outcomes our future generations deserve. As we return power to states, we must shift our oversight role at CMS to one that focuses less on process and more on holding us all collectively accountable for achieving positive outcomes.

That is precisely why, last November, I announced that we would create the first ever CMS Medicaid and CHIP Scorecard to increase public transparency about the programs’ administration and outcomes. The data offered within the Scorecard begins to offer taxpayers insights into how their dollars are being spent and the impact those dollars have on health outcomes.  The Scorecard includes measures voluntarily reported by states, as well as federally reported measures in three areas: state health system performance; state administrative accountability; and federal administrative accountability. As states continue to seek greater flexibility from CMS, the Scorecard will serve as an important tool in ensuring that CMS is able to report on critical outcome metrics.

The first version of the Scorecard is foundational to CMS’s ongoing efforts to enhance Medicaid and CHIP transparency and accountability. We’ve begun this initiative by publishing selected health and program indicators that include measures from the CMS Medicaid and CHIP Child and Adult Core Sets along with federal and state accountability measures. For the first time, we are publicly publishing measures that show how we are doing in the business of running these immense programs, including things like how quickly we review state managed care rate submissions or approve state section 1115 Medicaid demonstration projects. Our stakeholders, including beneficiaries, providers, and advocates, deserve to have this information available to them.

And we’re just getting started. Public reporting of meaningful quality and performance metrics is an important and ongoing responsibility of states and the federal government given Medicaid’s vital role in covering nation’s children and as the single greatest payer for long-term care services for the elderly and people with disabilities.

That’s why, in future years, the Scorecard will be updated annually with new functionality and new metrics as data availability improves, including measures that focus on program integrity as well as opioid and home and community-based services quality metrics. Over time, we plan to add the ability for users of the Scorecard to generate year-to-year comparisons on key metrics, as well as to compare states on measures of cost and program integrity. While some variation may be inherent based on geographic, population, reporting or programmatic differences, the public should have access to information that allows them to understand how and why costs and outcomes can vary from state to state for the same populations. Then we can begin to ask important questions about what may really be driving differences in quality and efficiency.

CMS recognizes that continued insight from our state partners is a critical component in the maintenance of the Scorecard. I want to thank all the states for their assistance in the creation of this first iteration, particularly the 14 states that served on the National Association of Medicaid Director’s workgroup over the last six months. Many of the measures are only possible because of the commitment from states to collect and report on these important metrics.  Through this partnership with states, CMS will continue to advance policies and projects that increase flexibility, improve accountability and enhance program integrity and are designed to fulfill Medicaid’s promise to help Americans lead healthier, more fulfilling lives.



from The CMS Blog https://ift.tt/2JcEszP
via IFTTT

Become a patron of The Carlisle Wellness Network. Show everyone that you think this service is worth at least a buck. Go to; https://www.patreon.com/carlislewellness and pledge one dollar per month and help improve the resources it takes to gather the articles you see here as well as create fresh content including interviews an podcasts. We only need one dollar per month from all of our patrons to give The Carlisle Wellness Network a bright furture in the health and wellness social media ecosystem.

Comments

Popular posts from this blog

Hair Pulling, Nail Biting, Skin Peeling and Biting

All my life I’ve bitten my nails. It’s caused me a lot of trouble, especially with my bipolar mother who has always thought screaming and shouting at me (and often a smack when I was younger) would make me stop.At around 7 I also started biting and peeling the skin on my fingers which has caused a lot of social and health issues for me from being to ashamed to join in with prayers at school, to getting my fingers getting a fungal infection causing long lasting damage to my fingers.Soon after I started to pull out the tiny hairs on my legs during school assembles and by 12 I began to pull my eyebrow hair out.How can I stop doing this to myself? I don’t even realise I’m doing it half the time (I started biting the skin around my fingers just writing this and caused it to bleed a little). I’m afraid to bring this up with my parents because of how they have reacted in the past and I’m far too embarrassed to ask anyone I would typically trust. It has severally impacted how I interact with …

Painful Memories Evoke More Intense Emotions in Those With Depression

People with major depressive disorder (MDD) experience more intense negative emotions while recalling painful memories compared to non-depressed people, according to a new study published in the journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.And although those with MDD were able to turn down their negative emotions about as well as non-depressed people, they used different brain circuits to do so.The new findings pinpoint brain differences in MDD associated with the processing of autobiographical memories — one’s memories of personal events and knowledge of one’s life — that help us develop our sense of self and guide our interactions with the world around us.“This study provides new insights into the changes in brain function that are present in major depression,” said journal editor Cameron Carter, M.D. “It shows differences in how memory systems are engaged during emotion processing in depression and how people with the disorder must regulate these systems i…

New video by FDMX Fitness on YouTube

TRX Back and Shoulder workout
Here we are back with the TRX Suspension trainer for a back and shoulder workout! We will be wearing our polar h7 heart rate monitors, to keep track of our heart rate zones and calories burned. We will be doing the following exercises in this TRX workout video 1. TRX Shoulder press 2. TRX Low Rows 3. TRX W-Drills/ TRX L-Drills 4. TRX Mid Rows 5. TRX Shoulder press 6. TRX High Rows 7. TRX W-Drills/ TRX L-Drills 8. TRX Mid Rows Be sure to check out all of our TRX workout videos at http://ift.tt/2n62Kj3


View on YouTube

Become a patron of The Carlisle Wellness Network. Show everyone that you think this service is worth at least a buck. Go to; http://ift.tt/2i70pBW and pledge one dollar per month and help improve the resources it takes to gather the articles you see here as well as create fresh content including interviews an podcasts. We only need one dollar per month from all of our patrons to give The Carlisle Wellness Network a bright furture in the health an…