title: State challenges to child health quality measure reporting and recommendations for improvement.
abstract: OBJECTIVE
  The Children's Health Insurance Program (CHIP) was re-authorized in 2009, ushering in an unprecedented focus on children's health care quality one of which includes identifying a core set of performance measures for voluntary reporting by states' Medicaid/CHIP programs. However, there is a wide variation in the quantity and quality of measures states chose to report to the Center's for Medicare & Medicaid Services (CMS). The objective of this study is to assess reporting barriers and to identify potential opportunities for improvement.
  
  
  METHODS
  From 2013 to 2014 a questionnaire developed in coordination with CMS and the Agency for Healthcare Research and Quality (AHRQ) was sent to state Medicaid and CHIP officials to assess barriers to child health quality reporting for Federal Fiscal Year 2012. States were categorized as high, medium, or low reporting for comparative analysis.
  
  
  RESULTS
  Twenty-five of the 50 states and the District of Columbia agreed to participate in the study and completed the questionnaire. States placed a high priority on children's health care quality reporting (4.2 of 5 point Likert Scale, SD 0.99) and 96% plan to use measurement results to further improve their quality initiatives. However, low reporting states believed they had inadequate staffing and that data collection and extraction was too time-consuming than high reporting states.
  
  
  CONCLUSIONS
  Based on state responses, possible solutions to improve reporting includes funding and staff support, refining the technical assistance provided, and creating venues for state-to-state interaction. Realistic and tangible improvements are within reach and opportunities for CMS and states to collaborate to improve child health care quality.
authors.affiliation: Children's National Health System, Washington, DC, USA. Electronic address: Anshah@cnmc.org.
authors.forename: Ankoor Y
authors.initials: AY
authors.lastname: Shah
authors.affiliation: Centers for Medicare and Medicaid Services, Baltimore, MD, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: LLanos
authors.affiliation: Agency for Healthcare Research and Quality, Rockville, MD, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Dougherty
authors.affiliation: Centers for Medicare and Medicaid Services, Baltimore, MD, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Cha
authors.affiliation: Centers for Medicare and Medicaid Services, Baltimore, MD, USA.
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Conway
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D002648:Child; D002662:Child Health Services / Q000592:standards* / Q000706:statistics & numerical data*; D002669:Child Welfare; D006801:Humans; D008484:Medicaid; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D013221:State Health Plans / Q000706:statistics & numerical data* / Q000639:trends; D011795:Surveys and Questionnaires; D014481:United States; D016270:United States Agency for Healthcare Research and Quality
keywords: CHIP; Medicaid; Quality