Step 1 to improve Medicaid and CHIP: compare apples to apples.

Parties on both sides of the health reform debate agree on at least one thing:  both desire significant improvement with respect to patient outcomes. And there is work we can do–together–that cuts across party lines.

If you think you understand the quality of care delivered through Medicaid and CHIP, you don’t. That’s because nobody does. There is no standard way to measure and report quality for these two programs. Although states partner with the Federal government to deliver health care through Medicaid and CHIP for nearly 80 million Americans with low incomes, there is no comprehensive way to assess the quality of care in Medicaid and CHIP across all health care delivery systems. While most managed care plans routinely collect and report quality data, there is precious little such reporting in ‘fee-for-service’ Medicaid.

This means that everyone, including policymakers in Congress and the Administration, have an incomplete picture of the quality of Medicaid and CHIP—and thus how effectively taxpayers’ money is spent.

This is unacceptable.

We need a standardized measure of health care data, so we can come up with an “apples to apples” comparison of health care outcomes across all of the U.S. The Medicaid and CHIP Quality Improvement Act would build on existing measures of care for adults and children by developing a framework for states to submit quality data to HHS – which would, in turn, submit a report to Congress. This would help not only people in Congress, but also leaders in statehouses around the country to make informed choices when they work to improve their Medicaid and CHIP programs–simply because they’ll have better information available to them.

The bill provides incentives for states that perform at a high level – and also provides incentives to states that show improvement in their quality. This will spark innovation at the state level and unlock the benefits of the Federalist “laboratory of democracy” model, while at the same time providing verifiable data that assures that Medicaid delivers the quality of care patients expect and deserve.

We’re not yet ready to have the debate we need on the future of the safety net for the simple reason that we still lack a fundamental understanding of what works best for patients. If the goal for both parties is to strengthen the safety net while improving healthcare outcomes, then we should be able to compare New York with Texas. We should be able to compare Minnesota with Missouri.

Ask your Member of Congress to support the Medicaid and CHIP Quality Improvement Act, so that our public discourse on the safety net isn’t just about competing arguments, but also about comparing sets of data.

Let’s compare apples to apples—and put patients first.


For more about the Medicaid and CHIP Quality Improvement Act, visit