Quality

This is the latest newsletter of the National Core Indicators (NCI) program. The publication is designed to keep you abreast of developments and best practices in performance and outcome measurement as exemplified in initiatives among NCI participants. Issue 1, Volume 3 explores mortality outcomes in Wyoming, Arizona and Connecticut.

Colorado Real Choice Quality grantees designed this worksheet to guide clients as they \"shop around\" for the best provider agency to meet their needs. The worksheet suggests questions and criteria to use in evaluating agency services from a consumer perspective.

The Colorado Department of Health Care Policy and Financing received a Real Choice Grant for quality and created this brochure for consumers as part of their quality improvement activities. This tool provides strategies, resources, and guidelines for addressing home care concerns and, when necessary how to file complaints.

This CMS letter provides a status update on the web-based version of the application for 1915(c) Home and Community Based waivers, the revised paper version of the waiver application (Version 3.3) and the evaluation of it, as well as the 373 S and Q.

This is the Quality Management Strategy for its 1115 Waiver covering managed care for non-elderly, non-dual MassHealth members. MassHealth, the state Medicaid Program, provides managed care services to eligible enrollees through its Managed Care Organization (MCO) Program, Primary Care Clinician (PCC) Plan, and the PCC Plan’s associated contracted behavioral health plan, and Senior Care Options (SCO). The Strategy incorporates the efforts and activities of several entities that serve enrollees.

To improve long-term care quality, state and federal policymakers are experimenting with positive incentives to reward providers who can demonstrate better quality. Incentive payment systems are part of a broader trend in the health care field, referred to as “pay-for-performance” and may consist of either financial payments or non-financial recognition. This paper describes the challenges involved in designing effective quality incentive payment systems in the long-term care sector.

The Department of Mental Retardation (DMR) has established a system of reporting and monitoring incidents that occur with individuals served by the department in order to identify, manage and reduce overall risk for the individual. This procedure delineates a standardized process for reporting, documentation and follow-up of reportable incidents as defined, involving individuals served by the department. This reporting system helps implement individual plans and assists in quality oversight.

The CMS Systems Change conference, Transforming Systems: Keys to Success was held April 10-12 in Baltimore. Presentations from the 2006 sessions are available in both PDF and text formats. Topics range from ideas on system transformation, stakeholder involvement, coalition building, strategic planning, sustaining systems change, and the Deficit Reduction Act. Full titles are listed in the keywords section.

This report focuses on the current system for critical incident reporting and tracking within long-term care waiver programs. It also includes recommendations from stakeholders on a definition of critical incident and emergency backup, policy recommendations for new mechanisms that would more appropriately address the needs of consumers, and outlines an implementation plan for new critical incident management mechanisms and statewide emergency backup infrastructure.

The Colorado Department of Health Care Policy & Financing contracted with an independent consultant to organize and facilitate six focus groups with consumers of Medicaid waiver services, family members or representatives, and consumer-directed program participants. The focus groups discussed consumer experiences with existing emergency backup and critical incident management systems and identified strengths and potential weaknesses. This report provides results from the focus groups.