You are at: Home Medicaid Performance Measures

Document Actions

Medicaid Performance Measures

last modified 02/05/2019 - 10:20 AM
Performance measures show how a program is doing. The Department of Vermont Health Access (DVHA) runs many measure sets to see how well Medicaid is working.
A large scorecard effort supported by Quality Unit staff is the DVHA's Performance Accountability Scorecard.  The scorecard contains over 70 performance measures across 20 units. Management Team members routinely report on their unit's performance measure data & analysis.  See the scorecard here:
Federal legislation called for the creation of core sets of healthcare quality measures to assess the quality of care for adults and children enrolled in Medicaid. The U.S. Department of Health & Human Services established the Adult and Child Core Sets to standardize the measurement of healthcare quality across state Medicaid programs, assist states in collecting and reporting on the measures, and facilitate use of the measures for quality improvement. DVHA reports these measure sets to the Centers for Medicaid and Medicare Services (CMS) on an annual basis. 
In 2005, the Legislature approved Vermont to participate in the Global Commitment Waiver. The waiver gives the DVHA the ability to be more flexible in the way it spends Medicaid dollars. The waiver changed the structure of State government. The DVHA is now the only Medicaid Office in the country operating as a managed care model.
The State believes that the use of a managed care model will allow Vermont to:
·         Purchase the best value health care;
·         Improve access to services;
·         Protect from substandard care.   
The Agency of Human Services requires the DVHA to run a set of Global Commitment Measures to show how the waiver is doing. AHS also requires that an external quality review organization confirm that these measures have been run correctly.
Click on the link to see DVHA's Global Commitment Scorecard
Click on the link next to the measure name in the chart below to see the individual measure results. 


Focus AreaPerformance Measure
Prevention & Screening

Adult BMI Assessment:

Breast Cancer Screening:  

Chlamydia Screening in Women:

UtilizationWell Child Visits in the First 15 Months of Life:
Well Child Visits in the 3rd, 4th, 5th & 6th Year of Life:
Adolescent Well-Care Visits:
Emergency Room Use:
Access/Availability of Care Annual Dental Visits:

Initiation of Alcohol & Other Drug Dependence Treatment:

Engagement of Alcohol & Other Drug Dependence Treatment:

Adults' Access to Preventive/Ambulatory Health Services:

Children's & Adolescent's Access to Primary Care Practitioners

 Behavioral Health 

Follow-Up After Hospitalization for Mental Illness - 7 days:

Follow-Up After Hospitalization for Mental Illness - 30 days:

 Respiratory Conditions

 Medication Management for People with Asthma