An Introduction to Medicaid and CHIP Eligibility and Enrollment Performance Measures

The Centers for Medicare & Medicaid Services (CMS) recently established 12 new Medicaid and CHIP eligibility and enrollment performance indicators for states to report beginning in October 2013. These indicators provide insight into the performance of new eligibility and enrollment policies established under the Affordable Care Act (ACA). In December 2013, CMS released initial reports for a subset of the indicators. This brief provides an overview of the new performance indicators; the initial data; and the opportunities and challenges associated with reporting, analyzing, and interpreting the data. In sum it finds:

• Reporting of the new eligibility and enrollment performance indicators marks a significant improvement in timely and actionable data reporting for Medicaid and CHIP.
• The initial reported data suggest that enrollment in Medicaid and CHIP was off to a strong start since the beginning of open enrollment for the new Health Insurance Marketplaces.
• States are in varying stages of readiness to report the indicators, and data gaps and limitations constrain analysis of early data.
• CMS will update the performance indicators monthly and, over time, plans to report the full set of measures, which will offer a broader view of Medicaid and CHIP eligibility and enrollment performance.
• As the quality and completeness of the performance data improve, they will provide more insight into program operations and allow for greater analysis both within and across states over time