New Medicaid Scorecard - Lots of Data, But How to Use It?

The Trump Administration has initiated a "Medicaid Scorecard" to examine how states fare in comparison to each other in their utilization of the Medicaid system. Medicaid has long been a fundamentally shared program between the federal government and states, with the feds providing a large portion of the funds, and the states having a great deal of control over how those funds are administered in terms of eligibility and benefits.

Medicaid currently covers more than 67 million individuals, while CHIP covers nearly 6.5 million, and is the largest insurance program in the country. In Maryland, Medicaid covers 1 in every 5 individuals. To learn more about Maryland's Medicaid program, who it serves, and its impact on the state economy visit our Medicaid Supports Maryland website.

Federal health officials want to give states more flexibility over Medicaid’s rules and benefits. Recently, the administration told states this year that it would encourage them to establish work requirements for enrollees, or require participation in other forms of “community engagement” to remain qualified for benefits.  Several states have already implemented, or are moving to implement work requirements, but there is currently no interest in that in Maryland.

Gathering data is easy, comparing it equitably across states is going to prove far, far more difficult. For instance, some states enroll all their Medicaid recipients in managed care programs, other states do not. Medicaid expansion states have a higher number of people with higher incomes, who may prove to be healthier overall than the states that didn't expand and have much poorer individuals on their rolls.

Some examples:

  • Adults on Medicaid with controlled high blood pressure ranged from 26% in Louisiana to 72% in Rhode Island.
  • Children ages 3 to 6 on Medicaid and CHIP receiving adequate doctors’ care varied from 48% in Alaska and Idaho to 86% in Massachusetts. 

The Medicaid and CHIP Scorecard can be found here

Where does Maryland stand? Find the data here.

Areas where Maryland scored well:

  • Infant and pediatric PCP visits. Well into the 90th percentile.
  • Immunizations - above the 80th percentile.

Areas where Maryland scored poorly (below the 50th percentile):

  • Any measure related to pediatric asthma care.

Perhaps the most striking disparity in all of the Maryland data:

  • Percentage of Women Delivering a Live Birth with a Prenatal Care Visit in the First Trimester or within 42 Days of Medicaid/CHIP Enrollment = 83.9
  • Percentage of Women Delivering a Live Birth who had More Than 80 Percent of Expected Prenatal Visits = 67.9

Like we said - lots of good data. We'll be able to use this to identify services crying out for expanded health literacy and equity campaigns in Maryland