Methodology & limitations

Relative benchmarking from public CMS Core Set rates — not a clinical or regulatory determination.

Band-position normalization

Raw Core Set rates are not comparable across measures — a 46% ED follow-up rate and a 90% immunization rate cannot be averaged. For each measure we place a state’s rate in the national inter-quartile band published in the CMS file: 0 at or below the bottom quartile, 1 at or above the top quartile, and linear in between. The result is a unitless position in the national distribution.

Direction flip

When CMS labels a measure as lower-rates-are-better, we invert the band so that higher band position always means better relative performance. The UI still shows the raw rate and a “lower is better” badge so a low dot is never misread as poor performance.

Row → measure → domain → state

Many Core Set measures publish several rate definitions (age bands, phases). We average band positions across rate definitions within the same program + abbreviation first, then average those measure-level bands within each domain. That keeps multi-rate measures from dominating a domain simply because they appear more times in the file.

Domain-equal overall composite

The default composite (overallBand) is the unweighted mean of the seven domain bands — domains with many measures do not automatically outweigh thinner domains. If a weight control is exposed in the UI, it recombines these precomputed domain scores in the browser; it does not re-score raw rates.

Domains (equal weight)

Behavioral Health Care
Care of Acute and Chronic Conditions
Dental and Oral Health Services
Experience of Care
Long-Term Services and Supports
Maternal and Perinatal Health
Primary Care Access and Preventive Care

Consistency

Consistency is the standard deviation of measure-level band positions for a state. Lower σ means the state sits in a similar part of the national band across measures; higher σ means strong on some and weak on others. The overview scatter inverts the axis so “up” reads as more consistent.

Reporting coverage

We always show n measures next to composites. A state reporting 34 measures and one reporting 55 are not equally comparable — see the Reporting Gap app for completeness vs composite.

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
States: 52
Measures: 139 rate definitions

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