2024 is the first year that Children's Health Insurance Program (CHIP) programs are required to report the full Child Core Set to CMS, which will help identify disparities and areas for improvement. From 2010 to 2020, the median number of Child Core Sets reported by states increased from 7 to 19. States with high rural populations such as South Dakota and Montana reported the lowest number of measures met, though rural patients on CHIP would likely benefit from remote care or telehealth services. As with HEDIS or Star, providers and health plans can improve Child Core Set adherence with key telehealth initiatives such as at-home diagnostics. 

What is CHIP?

CHIP stands for the Children's Health Insurance Program. It is a government program in the United States that provides health coverage to eligible children up to age 19, ensuring they have access to necessary medical services. CHIP is designed to assist families with low to moderate incomes who do not qualify for Medicaid but may find it challenging to afford private health insurance for their children. The program helps bridge that gap, making sure that children receive essential healthcare services and lead healthier lives.

What is the Child Core Set?

In 2009, the Children's Health Insurance Program Reauthorization Act (CHIPRA) introduced measures to enhance the quality of care and health outcomes for children on Medicaid and CHIP. This led to the creation of the Child Core Set, incorporating various quality measures for both physical and mental health. As of 2024, states are required to report on the Child Core Set, which will undergo annual updates. Future updates will be communicated in advance, enabling states to adapt before mandatory reporting periods.

What does the Child Core Set measure?

CMS identified a mandatory core set of measures as well as 18 behavioral health measures for reporting by state Medicaid and CHIP agencies. The Child Core Set is an assessment tool to measure and track patient receipt of preventative services such as immunizations as well as primary care, dental care, management of acute conditions, and behavioral health. 

At-home diagnostics for the Child Core Set  

Telehealth services such as at-home diagnostics can eliminate barriers to care for patients on CHIP, including parents' ability to take off work or maintain reliable transportation to attend in-person visits. Below are three ways health plans can meet CHIP requirements through the implementation of at-home diagnostics programs. 

1. Preventative Programs: Preventative screening programs help detect health conditions at an early stage when treatment is often more effective. The Child Core Set requires providers to record lead screening in children. This screening helps identify children who have elevated lead levels, which can result from exposure to lead-based paint, contaminated water, or other environmental sources. Lead poisoning in children can lead to developmental delays, learning difficulties, behavioral problems, and other serious health issues. Lead screening, as with other kinds of testing programs, can utilize at-home diagnostics to test more patients. Providers and health plans can send kits home with parents or mail them directly to the house. 

2. Diabetes Care: 2024 Mandatory Core Set of Behavioral Health Measures requires plans to report diabetes screening and care for patients with certain serious mental health disorders. As with Star Ratings, CMS wants a record of people with poor HbA1c control (>9.0%) on CHIP. Dried blood spot cards allow patients to collect a sample at home and submit it to a lab for review. In addition to meeting Core Set requirements, providers can also flag which patients need additional diabetes care. 

3. STI Screening Measures: The 2024 Child Core Set requires states to report certain STI screenings for adolescents, such as chlamydia in women ages 16 to 20. Chlamydia poses significant risks for patients, including potential complications such as pelvic inflammatory disease (PID) that may lead to fertility issues. Untreated chlamydia in this age group can increase the risk of ectopic pregnancies and other reproductive health problems. As with other preventative screening measures, providers and health plans can initiate remote chlamydia screening programs to reach more patients and meet Child Core Set requirements. Patients receive kits, which may include dried blood spot cards or swabs, and self-collect samples at home.   

How Ash Wellness can boost Child Core Set measures 

The 2024 reporting requirement is a crucial step in identifying healthcare disparities and areas for improvement within CHIP programs. States have shown progress in reporting, but challenges persist, especially in rural areas. By leveraging technologies, providers and health plans can enhance Child Core Set adherence, ensuring that children on CHIP receive the essential care they need for a healthier future. 

Ash Wellness collaborates with health plans in the United States to introduce effective white-labeled at-home diagnostics programs. The Ash Platform and a team of remote diagnostics experts oversee the entire testing process, from technical integration to last-mile client service to ensure a comprehensive and seamless experience. 

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