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This page contains links to tools, protocols, and useful information for planners and managers of Medicaid quality processes. - The EQR Managed Care Organization Protocol describes the process for review of EQRO performance.
- The CHCS ROI Calculator offers a simple, intuitive process for determining the probable payoff for quality initiatives in Medicaid and SCHIP.
- The NCQA Medicaid Managed Care Toolkit 2008 Health Plan Accreditation Standards provides NCQA guidance regarding how State Medicaid agencies can use information obtained from NCQA accreditation surveys to help meet requirements of Federal regulations at 42 CFR 438 Subpart E while avoiding duplication of effort. While not an official CMS document, this toolkit has been reviewed by CMS staff, and States may find it a useful resource.
AHRQ Tools for Disease Management In May 2008, the Agency for Healthcare Research and Quality (AHRQ) released a package of tools to help decision-makers responsible for operating Medicaid fee-for-service or primary care case management programs to plan, develop, implement and evaluate their disease or care management programs. These documents are "Designing and Implementing Medicaid Disease and Care Management Programs: A User's Guide" (AHRQ Publication No. 07(08)-0063), "Monitoring and Evaluating Medicaid Fee-for-Service Care Management Programs: A User's Guide" (AHRQ Publication No. 08-0012), and "Patient Self-Management Support Programs: An Evaluation" (AHRQ Publication No. 08-0011). In addition, AHRQ funded the research that formed the basis for an article entitled, "Management Tools for Medicaid and State Children's Health Insurance Program (SCHIP)", which is intended to support State efforts to make more effective use of administrative data for quality-related purposes. These publications are available via the links and download below:
Page Last Modified: 10/21/2008 8:40:26 AM
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