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Showing results for "managed".

21. Value Set Export (pdf file)
    www.qualitymeasures.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

22. Value Set Export (xls file)
    www.qualitymeasures.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

23. Value Set Export (xls file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/0082cesareancoding.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

24. Comparative Reports on Health Plans | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/talkingquality/resources/comparative-reports/health-plans.html
    December 01, 2022 - Report Title: Medi-Cal Managed Care Health Care Options Website: https://www.healthcareoptions.dhcs.ca.gov … Location: California Synopsis: The California Department of Health Care Services’ website on Medi-Cal managed … Report Title: Managed Care Regional Consumer Guides Website: https://www.health.ny.gov/health_care … State Department of Health Developer Type: State government Location: New York Synopsis: The Managed

25. CAHPS Home and Community-Based Services (HCBS) Survey Database | Agency for Healthcare Research and Quality
    www.qualitymeasures.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

26. Improving Your Laboratory Testing Process | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/hai/tools/ambulatory-care/lab-testing-toolkit.html
    January 01, 2018 - increase the reliability of the testing process in your office by helping you examine how tests are managed … The tools will help you examine how tests are managed in your office, from the moment tests are ordered

27. Strategy 6E: Rapid Referral Programs | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/access/strategy6g-rapid-referral.html
    April 01, 2023 - Making patient care easier under multiple managed care plans. Fam Prac Manag February 1998. … 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 plan … Wrestling with the managed care octopus, Part 3. Get insurance authorizations faster.

28. Spotlight on Illinois -- The National Evaluation of the CHIPRA Quality Demonstration Grant Program (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/statesummaries/chipra-750-illinois-state-snapshot.pdf
    January 01, 2018 - compares its performance with national benchmarks.2 The State also started: (1) requiring Medicaid managed … con- vened a work group to analyze emergency department use data and then integrated into Medicaid managed … in response to recommendations from a CHIPRA demonstration workgroup, Illinois started to require managed … Key demonstration takeaways • The use of managed care contracts was a successful way to drive statewide … • Partner with Medicaid managed care organizations to continue to support practices in medical home

29. 4. Observations About the Evaluation | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/final-report/section4.html
    October 01, 2015 - comprehensiveness of the Medicaid administrative data were compromised by lack of encounter data from managed … Many of the Category C States have high use of Medicaid managed care among child beneficiaries, with … 45 to 90 percent of children in managed care in Florida, Massachusetts, Oregon, South Carolina, Utah, … Most states could not provide managed care encounter data. … Without data from managed care organizations, our evaluations would have represented a small proportion

30. CAHPS Home and Community-Based Services Survey | Agency for Healthcare Research and Quality
    www.qualitymeasures.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

31. Major Health Plan Quality Measurement Sets | Agency for Healthcare Research and Quality
    www.qualitymeasures.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

32. About the Measure | Agency for Healthcare Research and Quality
    www.qualitymeasures.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

33. Table 5. Evidence Supporting Emergency Department Pain Assessment for Children With Sickle Cell Disease (pdf file)
    www.qualitymeasures.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

34. Technical Appendix | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tap.html
    December 01, 2012 - The data also included personal attributes of HCBS participants (age, gender, race/ethnicity, managed … acute or managed long-term care plan for any month of the year (or quarter) (if any monthly PS file … Managed long-term care plan, enrollment in a . … For purposes of Table 3 , HCBS participants were classified as being enrolled in a managed long-term … care plan if the MAX data indicated enrollment in a managed long-term care plan or in a Program for

35. Value Set Export (xls file)
    www.qualitymeasures.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

36. Lessons from the Field: Identifying Measurement Challenges and Successes (pdf file)
    www.qualitymeasures.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

37. 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
    www.qualitymeasures.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/

38. Primary Care Practice Facilitation Curriculum Module 3: The Primary Care Landscape (pdf file)
    www.qualitymeasures.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.

39. Appendix Q. Surgeon Focus Group Content Analysis | Agency for Healthcare Research and Quality
    www.qualitymeasures.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

40. Outcome Indicators for the HCBS Population | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/find4.html
    December 01, 2012 - We exclude individuals in a managed acute care plan or a managed long-term care plan. … Thus, we exclude the entire State of Arizona, which has managed acute care for all Medicaid beneficiaries