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www.healthcare411.ahrq.gov/talkingquality/distribute/placement/settings.html
January 01, 2023 - People with well-managed chronic conditions may be both highly motivated and quite able to use quality … social service providers, public health facilities) to host free workshops to educate people about managed
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www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/childhealth/usingthecoresetofqm.pdf
February 01, 2010 - addition, some States are using the measures to produce
performance reports for providers, families, managed … to Improve Quality
Produce performance reports for
Providers X X X X X X X X
Families X X X X X
Managed
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www.healthcare411.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/highlight11.html
April 01, 2015 - We think it was a landmark document because it will [allow us to] compare the various Medicaid Managed … for the Alaska Medicaid Coordinated Care Initiative. a
Florida
Florida Medicaid is requiring managed … Illinois
Illinois Medicaid is requiring managed care organizations and accountable care entities … b Accountable care entities are integrated delivery systems similar to managed care organizations. … Illinois’s inclusion of Child Core Set measures in its contracts with accountable care entities and managed
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www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/qde-mmd-webinar-on_quality-measure-use.pdf
September 24, 2015 - improvement workgroups
– Encouraged consistent quality reporting standards across programs
– Required managed … With asthma will be managed effectively and control
maximized
Broad Focus on Quality
• Simultaneously … demonstrating improvement
David Kelley
30 30
Pennsylvania Medical Assistance
• Mandatory managed … care
• Over 1.1 million children covered by Medicaid
• Managed Care Organizations reporting both
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www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/highlight11.pdf
September 08, 2015 - We think it was a
landmark document because it will
[allow us to] compare the various
Medicaid managed … example, Florida and
Illinois are reporting measures for their
State as a whole and for each Medicaid
managed … Illinois • Illinois Medicaid is requiring managed care organizations and accountable care entities to … and utilization review program.
bAccountable care entities are integrated delivery systems similar to managed … Illinois’s inclusion of Child
Core Set measures in its contracts with
accountable care entities and managed
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www.healthcare411.ahrq.gov/funding/training-grants/disgrants.html
October 01, 2014 - 8/31/2015
Van Parys, Jessica
R36 HS23504-01
Columbia University Health Sciences
Mandating Managed … Outcomes
11/9/2015
Yeung, Kai
R36 HS23346-01A1
University of Washington
Incentivizing Value in Managed
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www.healthcare411.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/communication/strategy6kculturalcompetence.html
March 01, 2020 - For example, Molina Healthcare, a Medicaid managed care organization, developed and aggressively marketed … Racial and ethnic differences in parents' assessments of pediatric care in Medicaid managed care. … Race/ethnicity, language, and patients' assessments of care in Medicaid managed care. … Health plan effects on patient assessments of Medicaid managed care among racial/ethnic minorities.
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www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-136-fullreport.pdf
July 01, 2018 - medications prior to
incidence emergency department (ED) visits and/or hospitalizations for children being managed … which asthma was a primary or secondary diagnosis
in children ages 2-21 who meet criteria for being managed … Among those who were sick
enough to need the ED, their asthma was well managed prior to the visit or … For those
whose asthma was not well managed, some will clearly have had system reasons for the lack … Consistency of care with national guidelines for children
with asthma in managed care.
-
www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/technical-specifications.pdf
March 03, 2021 - This measure estimates the rate of emergency department visits for children ages 3 – 21 who are being
managed
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www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/chipra-factors-influencing-state-reporting.pdf
July 01, 2016 - States with high Medicaid managed care penetration—
Oregon and Pennsylvania—reported measures using … Oregon produced the measures within its
Medicaid agency, using encounter data that managed care
plans … That
experience prompted the state to require managed care
plans to provide complete and accurate … care contracts to enable reporting of the
Child Core Set
Oregon’s Medicaid managed care plans have … American Journal of
Managed Care, 13, 553–558.
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www.healthcare411.ahrq.gov/pqmp/measures/index.html?page=4
March 30, 2024 - Pediatric Quality Measures (CAPQuaM)
Distribution of Emergency Department Visit Use for Children Managed … Advancing Pediatric Quality Measures (CAPQuaM)
Rate of Emergency Department Visit Use for Children Managed
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www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/keydriver-sfcollaborative.pdf
January 24, 2018 - SMART Aim:
Reduce # of ED
visits/100 child‐
years for
children
managed for
persistent
asthma
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www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/keydriver-vtcollaborative.pdf
January 24, 2018 - SMART Aim:
Reduce # of ED
visits/100 child-
years for
children
managed for
persistent
asthma
-
www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/duration/chipra-157-bibliography.pdf
June 12, 2018 - The impact of Medicaid managed care on
hospitalizations for ambulatory care sensitive conditions.” … Churning in Medicaid managed care and its effect on
accountability. … Medicaid managed care encounter data: Collection and use. … care utilization by children with chronic illnesses: A
comparison of Medicaid and employer-insured managed
-
www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/duration/chipra-155-bibliography.pdf
May 08, 2018 - The impact of Medicaid managed care on
hospitalizations for ambulatory care sensitive conditions. … Churning in Medicaid managed care and its effect on
accountability. … Medicaid managed care encournter data: Collection and use. … care utilization by children with chronic illnesses: A
comparison of Medicaid and employer-insured managed
-
www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/asthma-ed-kdd.pdf
March 10, 2021 - Secondary Drivers Examples of Interventions
Reduce the # of ED
visits/100 child-
years for children
managed
-
www.healthcare411.ahrq.gov/policymakers/chipra/overview/background/next-steps2.html
December 01, 2009 - As noted above, almost half of Medicaid- and CHIP-enrolled children are not in managed care plans, and … improved considerably after program implementation. 35 The greatest increases were in California (two managed … at health plan and provider levels, and reports are made by health plans participating in Medicaid managed … In 2007, the national mean performance rate across Medicaid managed care health plans reporting to NCQA … measure of annual dental visits because the HEDIS measure is reported by NCQA only for children in managed
-
www.healthcare411.ahrq.gov/cahps/news-and-events/news/index.html
February 01, 2024 - Survey Database includes 6,053 survey responses voluntarily submitted by State Medicaid agencies and managed … Survey Database includes 4,731 survey responses voluntarily submitted by State Medicaid agencies and managed
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www.healthcare411.ahrq.gov/ncepcr/research-transform-primary-care/transform/final-impact/tab1.html
October 01, 2015 - Incentives and PCMH recognition
Participating Medicaid managed care organizations offered PCMH incentives … Community health worker program serving high-risk enrollees in Medicaid managed care while helping New
-
www.healthcare411.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/supln-slides.html
January 01, 2016 - plan measures
Data sources
Primarily Medicaid/CHIP administrative data (enrollment and claims or managed … Historical Context
SC Medicaid
Covers about 22-25% of population, 52% of all births
Majority Managed … Analysis – Program and Policy
Technical Assistance & Evaluation Support
Geo-spatial analysis
Managed … They include: CHIPRA Core QI Indicators (HEDIS NCQA, PQI, and NQF), HEDIS NCQA Managed Care and Fee for … , Agency Internal and External Supported Initiatives (including Hospital Associated Triple Aim, and Managed