Methodology & limitations

The Child and Adult Core Sets never share a measure abbreviation. This app reconstructs a like-for-like-looking comparison at the domain level — so the caveat below is not optional.

The five shared domains

The Child Core Set and Adult Core Set each organize measures into domains. We compare only the domains both programs measure — the child-only domain (Dental and Oral Health Services) and the adult-only domain (Long-Term Services and Supports) are excluded because there is no counterpart to compare against.

Behavioral Health Care
Care of Acute and Chronic Conditions
Experience of Care
Maternal and Perinatal Health
Primary Care Access and Preventive Care

Band-position core

Each reported rate is placed in the national inter-quartile band (0 = bottom quartile, 1 = top), direction-flipped when lower rates are better — the same normalization used in the State Core Set Scorecard. For a given state and domain, we take the domain-equal mean of the child program’s band positions (its child composite) and, separately, the adult program’s (its adult composite). The delta is child composite − adult composite.

delta = child − adult+ children fare better− adults fare better

Both programs required

A (state, domain) pair is emitted only when the state reported at least one measure for both the Child and Adult Core Sets in that domain. When one side is missing, the cell is omitted entirely — never zeroed or imputed — so no delta rests on a one-sided estimate. Across all states this yields 235 comparable cells covering 52 states.

Why it is not like-for-like

Even within a shared domain, the child and adult measure sets differ — different measures, ages, and specifications. A positive delta means children sit higher in the national band than adults for that domain, not that the same measure changed. Read the deltas as a directional signal that a state’s child and adult programs diverge, then confirm the specifics in the underlying measures.

Provenance

Source: CMS 2024 Child & Adult Health Care Quality Measures (Medicaid/CHIP Core Sets); Mathematica analysis of the QMR system as of 2025-04-28
As of: 2025-04-28
Core Set year: 2024
Methodology: v1.0.0
Generated: 2026-07-16T19:45:19Z

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