Medicaid Managed Care - U.S. Senate Special Committee on Aging

166
Quality
<strong>Special</strong> Needs Population
Patricia MacTaggart
July 15, 1997
Value-based, beneficiary-centered purchasing:
* access
* accountability
* quality services
* afford ability
* enrollee satisfaction
* responsive to individual health needs
Federal-state partnership:
* communication
* coordination
* collaboration
Evaluating services:
* point of view of the beneficiary
* standardized performance measures for provider feedback
and quality improvement-
Approach:
* defining where we want to go
* completing an inventory of what is currently being done/not done
* how the pieces fit
* how organizationally make it work
Components of value-based, beneficiary-centered purchasing quality strategy:
* who are we purchasing for: eligibility, outreach, enrollment
* who to contract with: purchasing tools
* what to contract for
* where and when to contract: contractor specifications
* how to monitor: quality oversight system
Priority: developing and implementing a <strong>Medicaid</strong> value-based, beneficiary-centered
purchasing strategy