This measure is important because the CMS Core Sets of healthcare quality measures for adult and children are often used to provide a snapshot of quality within Medicaid. They are not comprehensive, but prior to their creation and implementation, performance measurement varied greatly by state, and it was not possible to glean an overall picture of quality. Statute requires CMS to release annual reports on behalf of the Secretary on the reporting of state-specific adult Medicaid quality information. 

The trendline above demonstrates DVHA’s commitment to increasing our CMS Core Set measure production. Doing so is key to the state’s ability to keep pace with other state Medicaid plans and to evaluate the effectiveness of our payment reform models.  Additionally, states’ ability to report on all Child and Behavioral Health Core Measures becomes mandatory starting with the Federal Fiscal Year (FFY) 2024 reporting period 

One of the biggest challenges that DVHA faces related to performance measure production has to do with measures that require data from data sources outside of administrative claims. This includes gathering clinical elements from medical records and other program documentation. DVHA is working with a new quality measure vendor that allows us to more easily pull in program data that provides a more holistic picture for quality measures where data is not easily accessible through claims. 

Narrative Updated:  12/19/2025

• DVHA Data Unit
• DVHA Clinical Services Team
• Quality measure production vendor

As we strive to report on all performance measures within the CMS core quality measure sets by MY 2026, the Risk and Quality Management team: 
•    Actively reviews new Core Set Reporting materials as it is released to understand measure reporting requirements.
•    Regularly collaborates with the Medicaid Data Warehouse & Analytic Solution (MDWAS) for data collection and analysis. 
•    Is working with a new quality measure vendor, which will complete all medical record review abstraction beginning in MY2025 and streamline quality measure collection.