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41. CAHPS Bibliography | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/cahps/bibliography/index.html?page=5
    January 01, 2024 - Care experiences of managed care Medicare enrollees near the end of life. … Market characteristics and awareness of managed care options among elderly beneficiaries enrolled in … How do the experiences of Medicare beneficiary subgroups differ between managed care and original Medicare … Differential item functioning by survey language among older Hispanics enrolled in Medicare managed care

42. Strategies for Improving Patient Experience with Ambulatory Care: Rapid Referral Programs (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/access/cahps-strategy-6e.pdf
    July 07, 2017 - Wrestling with the managed care octopus, Part 3. Get insurance authorizations faster. … Patients’ satisfaction when denied authorization for emergency department care by their managed care … Wrestling with the managed care octopus, Part 3. Get insurance authorizations faster. … Making patient care easier under multiple managed care plans.

43. CAHPS Home and Community-Based Services Survey | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/cahps/surveys-guidance/hcbs/index.html
    November 01, 2023 - for voluntary use by State Medicaid programs, including both fee-for-service HCBS programs as well as managed … Aggregated Results for the Home and Community-Based Services Survey State Medicaid agencies and the managed

44. Daily Goals Checklist | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/hai/cusp/toolkit/daily-goals.html
    December 01, 2012 - communication is particularly important in the unit if complicated care plans are to be effectively managed … communication is particularly important in the unit if complicated care plans are to be effectively managed

45. Part 4: CME Design Features | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/implementation-guides/implementation-guide2/implguide2pt4.html
    September 01, 2014 - Medicaid managed care organizations. Cross-agency committees or purchasing collaboratives. … care organizations if behavioral health services are provided under a managed care arrangement. … Maryland’s Medicaid-funded CMEs will be managed at the county level to increase local control. … Level of CME Management: State or Local CMEs can be managed at the State or local level. … States may choose to include all services managed by a given funding agency in the case rate or carve

46. Synthetic Healthcare Database for Research Description of Data Elements (Codebook) (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Codebook.pdf
    December 01, 2023 - Medicaid managed care provides for the delivery of Medicaid health benefits and additional services … through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs … Missing 1 Encounter claims (i.e., Medicare Advantage or Medicaid managed care organizations) do not … Missing 1 Encounter claims (i.e., Medicare Advantage or Medicaid managed care organizations) do not … Missing 1 Encounter claims (i.e., Medicare Advantage or Medicaid managed care organizations) do not

47. About the Measure | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/pqmp/implementation-qi/toolkit/asthma/about.html
    July 01, 2021 - Department Use measure estimates the rate of emergency department (ED) visits for children who are being managed … Specifications and Reporting This measure estimates the rate of ED visits for children ages 3-21 who are being managed

48. Major Health Plan Quality Measurement Sets | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/talkingquality/measures/setting/health-plan/measurement-sets.html
    December 01, 2022 - HEDIS ® HEDIS refers to a widely used set of performance measures in the managed care industry. … HEDIS is managed by the National Committee for Quality Assurance (NCQA), a private, non-profit organization

49. Table 5. Evidence Supporting Emergency Department Pain Assessment for Children With Sickle Cell Disease (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-0217-section-5-table-5.pdf
    April 01, 2014 - Patients must be reassured that when they do experience pain it will be taken seriously and managed … Most SCD pain can be managed well if the barriers to assessment and treatment are overcome; a comprehensive … Many uncomplicated episodes can be managed at home with oral fluids; oral analgesics (ibuprofen, acetaminophen

50. Value Set Export (xls file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/0084coding.xls
    January 01, 2012 - SHIELD PHDSC 2.16.840.1.113883.221.5 Payer Individual Characteristic Source of Payment Typology 4.0 7 MANAGED … 2.16.840.1.113883.221.5 Payer Individual Characteristic Source of Payment Typology 4.0 11 Medicare (Managed … 2.16.840.1.113883.221.5 Payer Individual Characteristic Source of Payment Typology 4.0 21 Medicaid (Managed … PHDSC 2.16.840.1.113883.221.5 Payer Individual Characteristic Source of Payment Typology 4.0 61 BC Managed … 2.16.840.1.113883.221.5 Payer Individual Characteristic Source of Payment Typology 4.0 119 Medicare Managed

51. Lessons from the Field: Identifying Measurement Challenges and Successes (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/lessons/lessons-challenges-successes.pdf
    January 01, 2019 - authors of the Anthem Public Policy Institute 2016 issue brief on quality measurement in Medicaid managed … In their issue brief on quality measurement in Medicaid managed care, the Anthem Public Policy Institute … The authors noted One key informant described challenges faced by a managed care plan when developing … The “Nuts and Bolts” Behind Quality Measurement in Medicaid Managed Care. … www.anthempublicpolicyinstitute.com/blog/the-nuts- and-bolts-behind-quality-measurement-in-medicaid-managed-care

52. Background Report for the Request for Public Comment on Initial, Recommended Core Set of Children's Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/policymakers/chipra/overview/background/next-steps.html
    December 01, 2009 - Fourteen of the measures are currently NCQA HEDIS measures reported by Medicaid managed care plans, two … for children enrolled in CHIP or children in States with limited or no Medicaid managed care. … care organizations. 11 Many States have no managed care presence. b In some States, children with … The measure is currently in use by 158 Medicaid managed care (MMC) health plans across 32 States. … In 2007, 22 of 36 State programs with managed care organizations/health insuring organizations (MCOs/

53. Primary Care Practice Facilitation Curriculum Module 3: The Primary Care Landscape (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/ncepcr/tools/PCMH/pcpf-module-3-primary-care-landscape.pdf
    September 01, 2015 - Managed care plans versus indemnity (FFS) plans. … Managed care organizations (MCOs) are health plans that contract with provider networks for the care … Primary Care Practice Facilitation Curriculum MODULE 3 M3-7 As managed care has evolved, however, … the distinctions between these managed care plan types have become less clear. … Therefore, indemnity plans can expose patients to greater financial risk than managed care plans.

54. Appendix Q. Surgeon Focus Group Content Analysis | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/research/findings/final-reports/ssi/ssiapq.html
    April 01, 2018 - The risks for a patient with managed comorbidities, or one who is compliant with medical recommendations … for emergency surgery patients versus those for elective surgery patients; risks for a patient with managed … comorbidities versus those for patients with poorly managed or undocumented comorbidities; risks for

55. Major Physician Measurement Sets | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/talkingquality/measures/setting/physician/measurement-sets.html
    January 01, 2023 - Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the managed … HEDIS is managed by the National Committee for Quality Assurance (NCQA), a private, non-profit organization

56. Attachment 3.1 References (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-145-materials-iii-a.pdf
    January 01, 2014 - outcomes with methylphenidate formulations among patients with ADHD: retrospective claims analysis of a managed … Quality of care for childhood attention- deficit/hyperactivity disorder in a managed care Medicaid program

57. Background Report for the Request for Public Comment on Initial, Recommended Core Set of Children's Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/policymakers/chipra/overview/background/appendix-a1.html
    December 01, 2009 - Inactivated Polio Vaccine IT Information technology KID Kids' Inpatient Database MCO/HIO Managed … Disorder MDE Major Depressive Episode MEPS Medical Expenditure Panel Survey MMC Medicaid Managed

58. Tools To Improve Diagnostic Safety | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/diagnostic-safety/tools/index.html
    March 01, 2024 - This toolkit helps ensure that diagnostic lab tests are accurately managed and shared with patients and … The tools help examine how tests are managed in the office, from the moment tests are ordered until the

59. A Practice-Based Intervention to Improve Care for a Diverse Population of Women with Urinary Incontinence (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/evidencenow/projects/urinary/evidencenow_optima.pdf
    January 01, 2024 - ) San Diego and associates have 80 eligible primary care offices, with 240 physicians, and a large managed … County Department of Health Services Primary Care Network (UCLA- Harbor Medical Center) has a large managed

60. Tool 4: Community Inventory (doc file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/mcaidread_tool4_comm_inv.docx
    September 02, 2016 - Consider: Medicaid resources: Managed care organization care managers, home and community-based services … ] · · Medicaid managed care organizations [high-risk-care management, social work, wraparound