PMID: 15235379Jul 6, 2004Paper

Quality oversight and improvement in Medicaid managed care

Journal of Public Health Management and Practice : JPHMP
Patrick J RoohanFoster Gesten

Abstract

New York State has been collecting performance data from managed care plans that serve the Medicaid population since 1993. The data come to the state via the Quality Assurance Reporting Requirements--a series of quality of care, access, and utilization measures, largely based on the Health Plan Employer Data and Information Set, as well as several New York State-specific measures. In addition to collecting the data, the state publishes the information, works with plans that have below average rates of performance and provides a number of program and financial rewards to plans for rates that demonstrate high quality care. An analysis conducted on quality of care measures indicates that: (1) performance rates are increasing over time, (2) Quality Assurance Reporting Requirements rates are generally higher than national benchmarks, (3) the disparity between commercial plan rates and Medicaid rates is diminishing, and (4) the variability in performance across plans is decreasing. The analysis conducted indicates that the performance measurement system constructed in New York is an effective means to monitor health plan performance, while at the same time enabling the state and local health units to monitor population health and acc...Continue Reading

References

Dec 1, 1994·The Annals of Thoracic Surgery·E L HannanM R Chassin
Jan 23, 1998·JAMA : the Journal of the American Medical Association·B E LandonA M Epstein
Sep 7, 1999·Public Health Reports·G W Rutherford, H D Backer
Feb 24, 2001·Journal of Urban Health : Bulletin of the New York Academy of Medicine·P J RoohanF C Gesten
Jan 22, 2002·Quality Management in Health Care·Patrick J RoohanAnne M Schettine
Feb 13, 2002·The Joint Commission Journal on Quality Improvement·Bruce E LandonArnold M Epstein
Sep 24, 2002·JAMA : the Journal of the American Medical Association·Donald M Berwick
Apr 4, 2003·Health Affairs·Judith H HibbardMartin Tusler
Oct 1, 2003·Health Affairs·Haiden A Huskamp
May 26, 2004·Journal of Public Health Management and Practice : JPHMP·Judith CukorStephen Friedman

❮ Previous
Next ❯

Citations

Sep 21, 2006·The Journal of Ambulatory Care Management·Patrick J Roohan
Jul 5, 2005·The International Journal of Health Planning and Management·D Simonet

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

© 2022 Meta ULC. All rights reserved