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  1. www.healthcare411.ahrq.gov/pqmp/measures/asthma-distribution-ed-visit.html
    August 01, 2021 - Program PQMP Measures Distribution of Emergency Department Visit Use for Children Managed … PQMP Grantees Distribution of Emergency Department Visit Use for Children Managed … August 2021 Internet Citation: Distribution of Emergency Department Visit Use for Children Managed
  2. www.healthcare411.ahrq.gov/pqmp/measures/asthma-rate-ed-visit.html
    August 01, 2021 - Measures Program PQMP Measures Rate of Emergency Department Visit Use for Children Managed … Improvement PQMP Grantees Rate of Emergency Department Visit Use for Children Managed … created August 2021 Internet Citation: Rate of Emergency Department Visit Use for Children Managed
  3. www.healthcare411.ahrq.gov/ncepcr/tools/cultural-competence/planclas.html
    July 01, 2019 - The Business Case for CLAS in Managed Care There is a plausible business case for plans to initiate … Although managed care was initially confined primarily to the private and commercial sector, recently … diverse groups, since they represent such a rapidly increasing share of the managed care market. … care utilization and are important to managed care accreditation performance (e.g., HEDIS). … Assessing the Managed Care Plan.
  4. www.healthcare411.ahrq.gov/ncepcr/tools/cultural-competence/oralling.html
    July 01, 2019 - Culturally and linguistically diverse group members currently comprise 50 percent of managed Medicaid … groups, since they represent such a rapidly increasing share of the managed care market. … care utilization and are important to managed care accreditation performance (e.g., HEDIS). … Step 2: Assess the Capabilities of the Managed Care Plan. … Step 3: Identify Points of Contact for Members of Managed Care Plans.
  5. www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/duration/chipra-153-section-8a.pdf
    January 01, 2011 - Additionally, while some states usually provide managed care claims, others do not (Byrd and Verdier … Testing managed care claims data quality in each state Managed care claims data is sometimes absent … from MAX, and what managed care data is reported is not always validated before inclusion. … In order to address this problem, we review the managed care (MC) data reporting relative to fee for … This provides a check on the completeness of managed care data in each state.
  6. www.healthcare411.ahrq.gov/cahps/surveys-guidance/echo/index.html
    May 01, 2022 - Users of the ECHO Survey have included State Medicaid agencies, State mental health agencies, managed … behavioral health organizations (MBHOs), and managed care organizations (MCOs). … care organization or managed behavioral healthcare organization. … Download the Managed Care Organization (MCO) Survey and Instructions (ZIP, 4 MB)—The MCO Survey asks … Download the Managed Behavioral Health Care Organization (MBHO) Survey and Instructions (ZIP, 4 MB)—
  7. www.healthcare411.ahrq.gov/ncepcr/tools/cultural-competence/index.html
    August 01, 2019 - Opportunities Oral, Linguistic, and Culturally Competent Services Guides for Managed … shifting demographic trends in health care, two guides offer approaches to defining cultural needs in managed … for a contractor from AHRQ's Integrated Delivery System Research Network to develop two guides for managed
  8. Value Set Export (xls file)

    www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/CHIPRA-BMI-Coding.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
  9. www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-141-section-12-table-4-5.pdf
    December 31, 2010 - 651,207 (79%) 177,805 (21%) Coverage for majority of eligibility months Fee-for-service ± Managed … Sensitivity and specificity for COMBO and PMCA in managed care and fee-for-service subsets of Washington … NC-CD Without CD Sensitivity Specificity Sensitivity Specificity Sensitivity Specificity Managed
  10. www.healthcare411.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/final-report/section6.html
    March 01, 2019 - Reauthorization Act of 2009, P.L. 111-3. 22 During our baseline analysis, Massachusetts was unable to link managed … So while they sent us managed care encounter data, we could not identify which managed care patients … By the time we determined Massachusetts had solved the linkage problem and could use managed care data
  11. www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-113-fullreport.pdf
    May 01, 2018 - Rate of Emergency Department Visit Use for Children Managed for Identifiable Asthma 1 Rate of Emergency … Department Visit Use for Children Managed for Identifiable Asthma Section 1. … Measure Name CAPQuaM PQMP Asthma I: Rate of Emergency Department Visit Use for Children Managed for … estimates the rate of emergency department (ED) visits for children ages 2-21 years who are being managed … Churning in Medicaid managed care and its effect on accountability.
  12. www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-235-section-5-table-3.pdf
    June 17, 2014 - Descriptive Study In this study documenting access to care for Medicaid managed care enrollees, 39% … of specialists listed as being in a managed care plan network were found to not participate in that … Access to Care: Provider Availability in Medicaid Managed Care.
  13. www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-200-section-6-a-cpqsc-hospitals.pdf
    November 21, 2017 - More than half of patients (53.00%) use Medicaid, 45.80% use Managed Care, and 1.20% use another form … More than half of patients use Managed care (57.75%) whereas 40.81% use Medicaid, 1.20% use another … majority of patients use either Medicaid (37.57%) or Blue Cross Blue Shield (35.95%) while 25.41% have Managed
  14. www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-199-section-6-a-cpqsc-participating-hospitals.pdf
    November 17, 2017 - More than half of patients (53.00%) use Medicaid, 45.80% use Managed Care, and 1.20% use another form … More than half of patients use Managed care (57.75%) whereas 40.81% use Medicaid, 1.20% use another … majority of patients use either Medicaid (37.57%) or Blue Cross Blue Shield (35.95%) while 25.41% have Managed
  15. www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-203-section-6-a-participating-hospitals.pdf
    April 25, 2017 - More than half of patients (53.00%) use Medicaid, 45.80% use Managed Care, and 1.20% use another form … More than half of patients use Managed care (57.75%) whereas 40.81% use Medicaid, 1.20% use another … majority of patients use either Medicaid (37.57%) or Blue Cross Blue Shield (35.95%) while 25.41% have Managed
  16. www.healthcare411.ahrq.gov/talkingquality/resources/writing/guidelines.html
    September 01, 2019 - Can Consumers Understand Managed Care Report Cards? Managed Care Interface 1998; 11(11): 91-95. … Managed Care Quarterly 1999; 7(3): 75-82.
  17. Value Set Export (xls file)

    www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/0085episiotomycoding.xls
    January 01, 2012 - 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 … 2.16.840.1.113883.221.5 Payer Individual Characteristic Source of Payment Typology 4.0 219 Medicaid Managed
  18. Value Set Export (xls file)

    www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/0085behaviorcoding.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
  19. Value Set Export (pdf file)

    www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-169-gestational-age-additional-specifications.pdf
    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
  20. www.healthcare411.ahrq.gov/cahps/cahps-database/hcbs-database/index.html
    March 01, 2024 - repository for survey results that have been voluntarily submitted by State Medicaid agencies and the managed … help evaluate, compare, and improve the quality of services provided by both fee-for-service HCBS and managed

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