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Health Home Quality Reporting

Health Home Quality Measure Reporting and Evaluation Activities

A goal of Medicaid health home programs is to improve health outcomes for beneficiaries with chronic conditions through coordinated care provided by an interdisciplinary team linking primary, behavioral health, and long term services and supports. The Centers for Medicare & Medicaid Services (CMS) established a core set of health home quality measures that states can report through the Quality Measure Reporting (QMR) system according to the schedule below. These quality and utilization measures will be used for ongoing monitoring and evaluation purposes across all state health home programs. CMS will publish the resources for reporting the 2025 Health Home Core Set in late 2024. The 2025 Health Home Core Set history table provides a history of the measures included in the Health Home Core Set.

  • For technical assistance related to calculating, reporting, or using the health home quality measures, submit your questions to the TA Mailbox at MACQualityTA@cms.hhs.gov
  • For assistance with using QMR, contact the QMR Helpdesk at MDCT_Helpdesk@cms.hhs.gov.

General Resources for Reporting Health Home Quality Measures

FFY 2024 Health Home Core Set Reporting Resources

State Reporting Starts: Fall 2024

Measure List and Technical SpecificationsFFY 2024 Health Home Core Set Measure List
FFY 2024 Health Home Resource Manual and Technical Specifications
Summary of Updates to the Health Home Core Set Resource Manual and Technical Specifications for FFY 2024
Value Set Directories FFY 2024 Health Home Core Set HEDIS Value Set Directory
FFY 2024 Health Home Core Set Non-HEDIS Value Set Directory
  
Additional Technical Assistance ResourcesFFY 2024 Expected Health Home Core Set Reporting Periods
FFY 2024 Data Quality Checklist
FFY 2024 Health Home Measurement Period Table
Allowance of Telehealth in the 2024 Child, Adult, and Health Home Core Set Measure Specifications
Calculating the Plan All-Cause Readmissions (PCR) Measure in the Adult and Health Home Core Sets
Overview of Substance Use Disorder Measures in the 2024 Child, Adult, and Health Home Core Sets
Calculating the Admission to a Facility from the Community (AIF-HH) Measure in the 2024 Health Home Core Set
Calculating State-Level Rates Using Data from Multiple Reporting Units
  
Guidance for Reporting in the Quality Measure Reporting (QMR) SystemState Preview Reports, State-Specific Comments, and Additional Reporting Resources
Reporting Stratified Results in the QMR System

Archived Reporting Resources

Annual Reporting on the Quality of Health Care for Medicaid Health Home Enrollees

Resources from Federal Evaluation Activities

Resources from State Reporting and Evaluation Activities

States have begun to publish findings from their own health home program evaluations. View state findings from their health home program reporting and evaluation activities.

Iowa:

Maine:

Maryland:

Minnesota:

Missouri:

New York: