• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Acumentra Health Issues Report on Washington's Medicaid Managed Care Program

Posted on: Tuesday, 20 February 2007, 15:01 CST

Acumentra Health, the external quality review organization (EQRO) for the Washington Health and Recovery Services Administration (HRSA), 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 Improvement Collaborative (CHIC), an innovative project that brings together Washington clinics to improve preventive care for children with asthma or attention deficit/hyperactivity disorder, 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 carefor 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) survey and Health Plan Employer Data and Information Set (HEDIS®*) measures.

* HEDIS is a registered trademark of the National Committee for Quality Assurance.

Acumentra Health is a nonprofit organization 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.

Source: Business Wire

More News in this Category