Acumentra Health Issues Report on Washington's Medicaid Managed Care Program.PORTLAND, Ore. -- Acumentra Health, the external quality review organization (EQRO EQRO External Quality Review Organization ) for the Washington Health and Recovery Services Administration (HRSA HRSA Health Resources & Services Administration (US) HRSA Historical Radio Society of Australia HRSA Hamilton Rating Scale for Anxiety HRSA Hotel and Restaurant Suppliers Association (Canada) ), has submitted its 2006 external quality review report evaluating the care delivered through the state's managed care program for Medicaid enrollees. "Overall, our review found that the health plans under contract with HRSA continue to provide high-quality care for the state's Medicaid enrollees," said Susan Yates Miller, contract manager for Acumentra Health. "Focused quality improvement efforts by HRSA and the plans have led to statewide improvements in some important measures of clinical care." Among other strengths, the annual report commended HRSA for funding the Children's Health Children's Health Definition Children's health encompasses the physical, mental, emotional, and social well-being of children from infancy through adolescence. Improvement Collaborative (CHIC), an innovative project that brings together Washington clinics to improve preventive care Preventive care is a set of measures taken in advance of symptoms to prevent illness or injury. This type of care is best exemplified by routine physical examinations and immunizations. The emphasis is on preventing illnesses before they occur. See also
A persistent pattern of inattention, hyperactivity and/or impulsiveness; the pattern is more frequent and severe than is typically observed in people at a similar level of development. , or who are overweight. "The CHIC exemplifies HRSA's collaboration with other health-related agencies to implement consistent collection and reporting of child-focused performance measures for prevention, wellness, and outcomes of chronic illness care," said Yates Miller. The report noted other high-level strengths of HRSA and the managed care program, including: * Pay-for-performance incentives that have spurred improvement in childhood immunizations and well-child care visit rates * Performance at or above the national Medicaid average in several clinical measures, including access to primary care for children and adolescents and timely prenatal and postpartum care for women * Formation of a new quality oversight committee to help ensure the integration of external quality review results into the state's quality improvement activities Acumentra Health's report recommended the following, in part: * Continue to incorporate pay for performance in the managed care contract * Dedicate funds for focused studies to improve preventive care for children * Encourage health plans to provide technical assistance to their providers who need training in quality improvement techniques and in implementing electronic medical record systems Acumentra Health assessed Washington's managed health care using a unique systems approach that considers HRSA's quality improvement strategy, measurement and monitoring resources, and interagency partnerships. Analysts from Acumentra Health rated health plan performance on composite measures of health care access, timeliness, and quality, based on sources such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS CAHPS Consumer Assessment of Health Plans Study CAHPS Consumer Assessment of Healthcare Providers and Systems ) survey and Health Plan Employer Data and Information Set The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance. (HEDIS HEDIS Health Plan Employer Data & Information Set Managed care An initiative by the National Committee on Quality Assurance to develop, collect, standardize, and report measures of health plan performances. ([R]*)) measures. (*)HEDIS is a registered trademark of the National Committee for Quality Assurance National Committee for Quality Assurance Medical practice A private, not-for-profit organization which has become the leading accreditor of managed care plans; in site visits, NCQA reviewers evaluate a managed care plan in terms of quality management, physicians' . Acumentra Health is a nonprofit organization Nonprofit Organization An association that is given tax-free status. Donations to a non-profit organization are often tax deductible as well. Notes: Examples of non-profit organizations are charities, hospitals and schools. dedicated to improving the quality and effectiveness of health care. Established in 1984, Acumentra Health's work spans the continuum of care, reaching all ages and economic levels, and all delivery settings. Acumentra Health contracts with Medicare to support effective, evidence-based health care for Medicare beneficiaries in Oregon and oversees the state's Medicare Beneficiary Protection Program. In addition, Acumentra Health contracts with state agencies, public health organizations and coalitions, health plans, hospitals, physicians and others to conduct healthcare quality assurance and quality improvement projects. As a leader in healthcare quality, Acumentra Health provides expertise in areas such as performance measurement and improvement, surveys, utilization management, healthcare data analysis, chronic disease management and electronic health records. For more information, visit www.acumentra.org. |
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