SlideShare ist ein Scribd-Unternehmen logo
1 von 22
Ohio’s Medicaid Managed Care Program
Why Managed Care? ,[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Managed Care - 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care: Value Added Benefits for Members ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care  Quality Strategy ,[object Object],[object Object],[object Object],[object Object],[object Object]
MCP Accountability System ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy - Summary Access Administrative Capacity Consumer Satisfaction Quality ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Access Domain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Access Domain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy Medicaid Managed Care: ABD Population  Members’ Access to Preventive/Ambulatory Health Services (HEDIS)
Ohio Medicaid Managed Care Quality Strategy – Administrative Capacity Domain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Administrative Capacity Domain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Administrative Capacity Domain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Consumer Satisfaction Domain ,[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Quality Domain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Quality Domain ,[object Object],[object Object],[object Object],[object Object],[object Object]
External Quality Review Activities (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Quality Domain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Quality Domain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ohio Medicaid Managed Care Quality Strategy – Quality Domain Medicaid Managed Care: CFC Population  Frequency of Ongoing Prenatal Care- Percent Who Received 81% of More of Expected Visits (HEDIS)
Overview:  Ohio’s Managed Care  Program Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Weitere ähnliche Inhalte

Was ist angesagt?

HIT Standards Committee Trudel CMS Rules
HIT Standards Committee Trudel CMS RulesHIT Standards Committee Trudel CMS Rules
HIT Standards Committee Trudel CMS RulesBrian Ahier
 
Medicare Advantage
Medicare AdvantageMedicare Advantage
Medicare AdvantageBen Quirk
 
Medicare Advantage
Medicare Advantage Medicare Advantage
Medicare Advantage Ben Quirk
 
PYA Looks Beyond Meaningful Use at AHIMA
 PYA Looks Beyond Meaningful Use at AHIMA PYA Looks Beyond Meaningful Use at AHIMA
PYA Looks Beyond Meaningful Use at AHIMAPYA, P.C.
 
Accountable Care Organizations (ACOs)
Accountable Care Organizations (ACOs)Accountable Care Organizations (ACOs)
Accountable Care Organizations (ACOs)Ben Quirk
 

Was ist angesagt? (15)

HIT Standards Committee Trudel CMS Rules
HIT Standards Committee Trudel CMS RulesHIT Standards Committee Trudel CMS Rules
HIT Standards Committee Trudel CMS Rules
 
Medicare Advantage
Medicare AdvantageMedicare Advantage
Medicare Advantage
 
Medicare Advantage
Medicare Advantage Medicare Advantage
Medicare Advantage
 
PYA Looks Beyond Meaningful Use at AHIMA
 PYA Looks Beyond Meaningful Use at AHIMA PYA Looks Beyond Meaningful Use at AHIMA
PYA Looks Beyond Meaningful Use at AHIMA
 
Webinar: Comprehensive Primary Care Plus - Health IT Vendor Overview
Webinar: Comprehensive Primary Care Plus - Health IT Vendor OverviewWebinar: Comprehensive Primary Care Plus - Health IT Vendor Overview
Webinar: Comprehensive Primary Care Plus - Health IT Vendor Overview
 
Webinar: State Innovation Models Initiative Round Two - Model Design Applicat...
Webinar: State Innovation Models Initiative Round Two - Model Design Applicat...Webinar: State Innovation Models Initiative Round Two - Model Design Applicat...
Webinar: State Innovation Models Initiative Round Two - Model Design Applicat...
 
Webinar: Medicare Diabetes Prevention Program - Overview
Webinar: Medicare Diabetes Prevention Program - OverviewWebinar: Medicare Diabetes Prevention Program - Overview
Webinar: Medicare Diabetes Prevention Program - Overview
 
Webinar: Oncology Care Model - Frequently Asked Questions and Application Ove...
Webinar: Oncology Care Model - Frequently Asked Questions and Application Ove...Webinar: Oncology Care Model - Frequently Asked Questions and Application Ove...
Webinar: Oncology Care Model - Frequently Asked Questions and Application Ove...
 
Webinar: MACRA, MIPS and APMs - Learn about the Request for Information Part 1
Webinar: MACRA, MIPS and APMs - Learn about the Request for Information Part 1Webinar: MACRA, MIPS and APMs - Learn about the Request for Information Part 1
Webinar: MACRA, MIPS and APMs - Learn about the Request for Information Part 1
 
Benchmarking Quality
Benchmarking QualityBenchmarking Quality
Benchmarking Quality
 
Webinar: Health Care Innovation Awards Round Two - Measuring for Success and...
 Webinar: Health Care Innovation Awards Round Two - Measuring for Success and... Webinar: Health Care Innovation Awards Round Two - Measuring for Success and...
Webinar: Health Care Innovation Awards Round Two - Measuring for Success and...
 
Webinar: Accountable Health Communities Model - Track 1 Overview and Applicat...
Webinar: Accountable Health Communities Model - Track 1 Overview and Applicat...Webinar: Accountable Health Communities Model - Track 1 Overview and Applicat...
Webinar: Accountable Health Communities Model - Track 1 Overview and Applicat...
 
Webinar: Medicare Advantage Value-Based Insurance Design Model - Overview of ...
Webinar: Medicare Advantage Value-Based Insurance Design Model - Overview of ...Webinar: Medicare Advantage Value-Based Insurance Design Model - Overview of ...
Webinar: Medicare Advantage Value-Based Insurance Design Model - Overview of ...
 
Accountable Care Organizations (ACOs)
Accountable Care Organizations (ACOs)Accountable Care Organizations (ACOs)
Accountable Care Organizations (ACOs)
 
MACRA 071916
MACRA   071916MACRA   071916
MACRA 071916
 

Ähnlich wie Ohio's Medicaid Managed Care Quality Strategy

Impact of HEDIS on Health Plans
Impact of HEDIS on Health PlansImpact of HEDIS on Health Plans
Impact of HEDIS on Health PlansCitiusTech
 
Value Driven Health Care
Value Driven Health CareValue Driven Health Care
Value Driven Health Carenashp
 
Health Reform & the Delivery System: A New Medley of Payment & Incentives
Health Reform & the Delivery System: A New Medley of Payment & IncentivesHealth Reform & the Delivery System: A New Medley of Payment & Incentives
Health Reform & the Delivery System: A New Medley of Payment & IncentivesNASHP HealthPolicy
 
HFMA - IT and DSRIP Technology Enabled Healthcare - Paul Contino
HFMA - IT and DSRIP Technology Enabled Healthcare - Paul ContinoHFMA - IT and DSRIP Technology Enabled Healthcare - Paul Contino
HFMA - IT and DSRIP Technology Enabled Healthcare - Paul ContinoPaul Brian Contino
 
Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...
Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...
Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...CitiusTech
 
Quality assurance in nursing
Quality assurance in nursingQuality assurance in nursing
Quality assurance in nursingNamita Batra
 
Lisa Hancock HCCA Board Compliance & Quality Presentation
Lisa Hancock HCCA Board Compliance & Quality PresentationLisa Hancock HCCA Board Compliance & Quality Presentation
Lisa Hancock HCCA Board Compliance & Quality PresentationLisa Hancock
 
Patient-Centered Medical Home: The Process and Initiative
Patient-Centered Medical Home: The Process and InitiativePatient-Centered Medical Home: The Process and Initiative
Patient-Centered Medical Home: The Process and InitiativeGreenway Health
 
Himss Overview, Madrid Cio Meeting
Himss Overview, Madrid Cio MeetingHimss Overview, Madrid Cio Meeting
Himss Overview, Madrid Cio MeetingMiguel Cabrer
 
The Electronic Health Record: Using It Effectively & with Meaning
The Electronic Health Record:Using It Effectively & with MeaningThe Electronic Health Record:Using It Effectively & with Meaning
The Electronic Health Record: Using It Effectively & with MeaningBU School of Medicine
 
Meaningful Use: The Fine Print
Meaningful Use: The Fine PrintMeaningful Use: The Fine Print
Meaningful Use: The Fine PrintQualifacts
 
Using Electronic Health Information and Strategic Analytics to Enhance Value ...
Using Electronic Health Information and Strategic Analytics to Enhance Value ...Using Electronic Health Information and Strategic Analytics to Enhance Value ...
Using Electronic Health Information and Strategic Analytics to Enhance Value ...Valence Health
 
The Business Value of Health: Turn-Key Employee Health Management
The Business Value of Health: Turn-Key Employee Health ManagementThe Business Value of Health: Turn-Key Employee Health Management
The Business Value of Health: Turn-Key Employee Health ManagementJ.P. Farley Corporation
 
4508 Final Quality Project Part 2 Clinical Quality Measur.docx
4508 Final Quality Project Part 2 Clinical Quality Measur.docx4508 Final Quality Project Part 2 Clinical Quality Measur.docx
4508 Final Quality Project Part 2 Clinical Quality Measur.docxblondellchancy
 
4508 Final Quality Project Part 2 Clinical Quality Measur
4508 Final Quality Project Part 2 Clinical Quality Measur4508 Final Quality Project Part 2 Clinical Quality Measur
4508 Final Quality Project Part 2 Clinical Quality Measurromeliadoan
 
Minnesota Efforts to Promote Nursing Home Quality
Minnesota Efforts to Promote Nursing Home QualityMinnesota Efforts to Promote Nursing Home Quality
Minnesota Efforts to Promote Nursing Home Qualitynashp
 

Ähnlich wie Ohio's Medicaid Managed Care Quality Strategy (20)

Impact of HEDIS on Health Plans
Impact of HEDIS on Health PlansImpact of HEDIS on Health Plans
Impact of HEDIS on Health Plans
 
Webinar: CMS Innovation Center Update
Webinar: CMS Innovation Center UpdateWebinar: CMS Innovation Center Update
Webinar: CMS Innovation Center Update
 
HI 225 Ch10 pp ts.ab202017
HI 225 Ch10 pp ts.ab202017HI 225 Ch10 pp ts.ab202017
HI 225 Ch10 pp ts.ab202017
 
Value Driven Health Care
Value Driven Health CareValue Driven Health Care
Value Driven Health Care
 
Health Reform & the Delivery System: A New Medley of Payment & Incentives
Health Reform & the Delivery System: A New Medley of Payment & IncentivesHealth Reform & the Delivery System: A New Medley of Payment & Incentives
Health Reform & the Delivery System: A New Medley of Payment & Incentives
 
Resume 3 (1)
Resume 3 (1)Resume 3 (1)
Resume 3 (1)
 
HFMA - IT and DSRIP Technology Enabled Healthcare - Paul Contino
HFMA - IT and DSRIP Technology Enabled Healthcare - Paul ContinoHFMA - IT and DSRIP Technology Enabled Healthcare - Paul Contino
HFMA - IT and DSRIP Technology Enabled Healthcare - Paul Contino
 
Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...
Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...
Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...
 
Quality assurance in nursing
Quality assurance in nursingQuality assurance in nursing
Quality assurance in nursing
 
Lisa Hancock HCCA Board Compliance & Quality Presentation
Lisa Hancock HCCA Board Compliance & Quality PresentationLisa Hancock HCCA Board Compliance & Quality Presentation
Lisa Hancock HCCA Board Compliance & Quality Presentation
 
Patient-Centered Medical Home: The Process and Initiative
Patient-Centered Medical Home: The Process and InitiativePatient-Centered Medical Home: The Process and Initiative
Patient-Centered Medical Home: The Process and Initiative
 
Making Sense of MACRA
Making Sense of MACRAMaking Sense of MACRA
Making Sense of MACRA
 
Himss Overview, Madrid Cio Meeting
Himss Overview, Madrid Cio MeetingHimss Overview, Madrid Cio Meeting
Himss Overview, Madrid Cio Meeting
 
The Electronic Health Record: Using It Effectively & with Meaning
The Electronic Health Record:Using It Effectively & with MeaningThe Electronic Health Record:Using It Effectively & with Meaning
The Electronic Health Record: Using It Effectively & with Meaning
 
Meaningful Use: The Fine Print
Meaningful Use: The Fine PrintMeaningful Use: The Fine Print
Meaningful Use: The Fine Print
 
Using Electronic Health Information and Strategic Analytics to Enhance Value ...
Using Electronic Health Information and Strategic Analytics to Enhance Value ...Using Electronic Health Information and Strategic Analytics to Enhance Value ...
Using Electronic Health Information and Strategic Analytics to Enhance Value ...
 
The Business Value of Health: Turn-Key Employee Health Management
The Business Value of Health: Turn-Key Employee Health ManagementThe Business Value of Health: Turn-Key Employee Health Management
The Business Value of Health: Turn-Key Employee Health Management
 
4508 Final Quality Project Part 2 Clinical Quality Measur.docx
4508 Final Quality Project Part 2 Clinical Quality Measur.docx4508 Final Quality Project Part 2 Clinical Quality Measur.docx
4508 Final Quality Project Part 2 Clinical Quality Measur.docx
 
4508 Final Quality Project Part 2 Clinical Quality Measur
4508 Final Quality Project Part 2 Clinical Quality Measur4508 Final Quality Project Part 2 Clinical Quality Measur
4508 Final Quality Project Part 2 Clinical Quality Measur
 
Minnesota Efforts to Promote Nursing Home Quality
Minnesota Efforts to Promote Nursing Home QualityMinnesota Efforts to Promote Nursing Home Quality
Minnesota Efforts to Promote Nursing Home Quality
 

Ohio's Medicaid Managed Care Quality Strategy

  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11. Ohio Medicaid Managed Care Quality Strategy Medicaid Managed Care: ABD Population Members’ Access to Preventive/Ambulatory Health Services (HEDIS)
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21. Ohio Medicaid Managed Care Quality Strategy – Quality Domain Medicaid Managed Care: CFC Population Frequency of Ongoing Prenatal Care- Percent Who Received 81% of More of Expected Visits (HEDIS)
  • 22.