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Title: Database of Publicly Available Medicaid and CHIP Performance Measure ReportsRelease Date: Monday, December 3, 2012Creator: Mathematica Policy Research, on behalf of the Centers for Medicare and Medicaid Services (CMS)Contract: HHSM-500-2010-0026I, Task Order HHSM-500-T0005

Explanation:

This database provides a snapshot of program performance measures that were reported online by states in spring 2012. The database allows users to see what types of information states were reporting online, and—if interested—to further explore the specifics of publicly available program performance measures by accessing the websites directly. The main portion of the database, contained within the worksheet entitled "Program performance measures," provides details on the types of measures reported, the data sources, the publication years, the frequency of reported data, and links to the websites. More information regarding the methodology used to assemble the database, and a description of its contents and potential uses, can be found in the accompanying user's guide.

To request more information or to provide feedback about this database, please email Brenda Natzke ([email protected]).

State Domains Covered

AKX

AK Adult Dental Program Facts

X X X

AK

X X

AK

X X

AK

X X

AK Cost, Utilization, and Efficiency

X

AK Overview of National and State Medicaid

X X

AK PERM Medicaid Review Program Integrity

X

Name of Specific Document(s) (if applicable)

Domain: Eligibility, Enrollment, and Retention

Domain: Access to Care

Domain: Provider Participation/ Network Adequacy

Domain: Consumer Experience

Domain: Quality and Outcomes of Care

Domain: Cost, Utilization, and Efficiency

Domain: Program Integrity

Domain: Delivery System Organization and Financing

2010-2014 Alaska’s Child and Family Services Plan

Eligibility, Enrollment, and Retention

•Eligibility, Enrollment, and Retention•Provider Participation/ Network Adequacy•Cost, Utilization, and Efficiency

Bring the Kids Home Update and 2 Year Plan

•Quality and Outcomes of Care•Cost, Utilization, and Efficiency

Department of Health and Social Services 2010 Annual Report

•Eligibility, Enrollment, and Retention•Cost, Utilization, and Efficiency

Long Term Forecast of Medicaid Enrollment and Spending in Alaska: 2005-2025


Medicaid Disproportionate Share Payments (first two pages of file named SB 168 documents 2-25-2010.pdf)


State Domains CoveredName of Specific Document(s) (if applicable)









AK Recipient Services Annual Report

X X X X

AK Cost, Utilization, and EfficiencyX

AL All Kids (CHIP) Enrollment DataX

AL Annual Report

X X X X

AR

X X X

AR

X X

•Eligibility, Enrollment, and Retention•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency

Transforming Health Care in Alaska 2010 Report/2010-2014 Strategic Plan

Eligibility, Enrollment, and Retention•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency•Program Integrity

Crossing the Finish Line: Moving Towards Covering All Kids

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience

Documents from the stakeholders meeting – “Bending the Curve – Medicaid Cost Reduction Strategies”, including: •Bending the Arkansas Medicaid Cost Curve – Presentation•Data — Part 1 (Eligibility)•Data — Part 2 (Expenditures & Utilization)•Handout from the Public Health Meeting on February 23, 2010•Exhibits A-D (Excel files of data presented)

•Eligibility, Enrollment, and Retention•Cost, Utilization and Efficiency










AR

X X

AR

X X

AR Medicaid Overview SFY 2011

X X X

AR Medicaid Quarterly Report

X X

AR

X X X

ARX

Eight Data sets (Excel), Services Incurred by Age Group (Excel), and supporting information (PDF)


Medicaid HCBS Waivers Annual Reports•Alternatives for Adults with Physical Disabilities (AAPD) Waiver•Alternative Community Services (ACS) Waiver•ElderChoices (EC) Waiver•Living Choices/Assisted Living Facility (LCAL) Waiver

•Program Integrity•Delivery System Organization and Financing

•Eligibility, Enrollment, and Retention•Provider Participation/ Network Adequacy•Cost, Utilization and Efficiency


Rehabilitative Services for Persons with Mental Illness (RSPMI) SFY 2010 Program Analysis

•Eligibility, Enrollment, and Retention•Provider Participation/ Network Adequacy•Cost, Utilization and Efficiency

State Fiscal Year 2004 Fiscal Agent's Annual Report

Provider Participation/Network Adequacy










AR

X X

AZ

X X

AZ AHCCCS Births

X X X

AZ AHCCCS Transparency Cost, Utilization, and Efficiency

X

AZ Program Integrity

X

AZ

X X

CA Health Plan Quality Measures X X

CA How Members Rate the PlansX X

CA Medi-Cal Drug Utilization Data Cost, Utilization, and EfficiencyX

The Economic Impact of Medicaid Spending in Arkansas

•Cost, Utilization and Efficiency•Delivery System Organization and Financing

•ALTCS Member Satisfaction Survey 2008•Member Satisfaction Survey (AHCCCS)•Provider Satisfaction Survey

•Provider Participation/Network Adequacy•Consumer Experience

•Eligibility, Enrollment, and Retention•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Corrective Action Plans, Notices to Cure, and Sanctions

EQRO Reports ALTCS contractors (reports also available for behavioral health services and children's rehab but contain less information in the domains of interest)

•Quality and Outcomes of Care•Program Integrity

•Access to Care•Quality and Outcomes of Care

•Access to Care•Consumer Experience










CA

X X X

CO

X X X

CO

X X X

CO

X X X

CO

X X X X X

CO

X X

CO

X X

CO Enrollment Data for Medicaid and CHP+X

Research and Analytical Studies Branch (RASB)

•Eligibility, Enrollment, and Retention•Quality and Outcomes of Care•Cost, Utilization, and Efficiency

2007-2008 External Quality Review Technical Report for BHOs

•Access to Care•Quality and Outcomes of Care•Program Integrity

Access to Medicaid Home and Community-Based Long-Term Care Services Performance Audit


Children's Basic Health Plan, Oversight of the State Managed Care Network Performance Audit

•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency•Program Integrity

Children's Basic Health Plan, Performance Audit

•Eligibility, Enrollment, and Retention•Access to Care•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Controls Over Medicaid Claims for Durable Medical Equipment and Supplies, Laboratory, and Radiology Services Performance Audit

•Cost, Utilization, and Efficiency•Program Integrity

Controls Over Payments Medicaid Community-Based Services for People with Developmental Disabilities












CO

X X X X

CO Medicaid Atlas

X X X

CO Medicaid Claims Performance Audit

X X X

COX X

CO

X X X X

CO Cost, Utilization, and Efficiency

X

CO

X X

CT

X

CT

X

CT

X

Implementation of the Medicaid Pediatric Hospice Waiver Program Performance Audit

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency


•Eligibility, Enrollment, and Retention•Program Integrity•Delivery System Organization and Financing

Medicaid Managed Care Ombudsman Annual Report

•Consumer Experience•Program Integrity

Medicaid Mental Health Rates Performance Audit

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency• Delivery System Organization and Financing

Medicaid Outpatient Substance Abuse Treatment Benefit Performance Audit

Office of the Colorado State Auditor Medicaid Prescription Drug Program. Performance Audit September 2004


•HUSKY A Enrollment Reports•HUSKY A Enrollment Growth


•HUSKY B Enrollment Reports•HUSKY B Enrollment Growth


A Preliminary Investigation on Health Plan Performance Report Cards for the Husky Program











CT Births to Mothers with Medicaid Coverage

X X X

CTX

CT Consumer Experience

X

CT

X X

CT Quality and Outcomes of CareX

CT

X

CT

X X

CT

X X

CT

X

CT

X


Council on Medical Assistance Program Oversight Enrollment, General Information, Enrollment


Council on Medical Assistance Program Oversight Enrollment, General Information, Enrollment

Fact Sheet: Integrating Care for CT’s Medicare‐Medicaid Eligibles


HUSKY A Early Periodic Screening, Diagnosis and Treatment ReportMedical Assistance Program Oversight Council, HUSKY B, Charter Oak & CT PCIP Programs Update


Report of the Commission on the Future of Hospital Care in Connecticut


Roundtable Summary, Comprehensive Teen EPSDT Screens


Trends in New Enrollment and Retention in the HUSKY Program


Trends in New Enrollment in the HUSKY Program: 2010











DC 2008 Annual Report

X X X X

DC

X X X

DC Managed Care Information

X X

DC Medicaid Fact Sheet FY 07

X X X

•Eligibility, Enrollment, and Retention•Provider Participation/ Network Adequacy•Quality and Outcomes of Care•Cost, Utilization and Efficiency•Delivery System Organization and Financing

2009 Consumer Report Card for Managed Care Organizations

•Access to Care•Consumer Experience•Quality and Outcomes of Care

•Eligibility, Enrollment, and Retention•Delivery System Organization and Financing











DE

X X

DE

X X X

FL

X X X

FL

X X X X X

FL

X X X X X

Joint Sunset Committee2006 Final Report, Division of Long Term CareResidents’ Protection

•Provider Participation/ Network Adequacy•Delivery System Organization and Financing

Promoting Community-Based Alternatives for Medicaid Long-Term Services and Supports for the Elderly and Individuals with Disabilities

•Eligibility, Enrollment, and Retention•Cost, Utilization and Efficiency•Delivery System Organization and Financing

•2008 Enrollee Satisfaction Survey•Medicaid Reform Enrollee Satisfaction Year 2 Follow Up Survey Vol 1 County Estimates•Medicaid Reform Enrollee Satisfaction Year 2 Follow Up Survey Vol 2 Plan Type Estimates•Enrollee Experiences with Mental Health and Substance Abuse Treatment and Counseling Services

•Access to Care•Provider Participation/ Network Adequacy•Consumer Experience

•A Study of the Quality of Children’s Mental Health Services within Florida’s Mental Health Managed Care Plans (policy brief #24)•A Study of the Quality of Children’s Behavioral Health Services within Florida’s Behavioral Health Managed Care Plans, A Sub-Study of the Agency for Health Care Administration (AHCA) Project, June 2005 (full report)

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care•Delivery System Organization and Financing

•Evaluation of the State Inpatient Psychiatric Program for FY 2004-2005 (policy brief #33)•Evaluation of the State Inpatient Psychiatric Program (SIPP) for FY 2004-2005, June 2005 (full report)

•Eligibility, Enrollment, and Retention•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing










FL

X X X X

FL

X X X X X X

FL

X X

FL 2006-07 Longitudinal Study

X X X X

FL

X X X X X

•LIP Report Milestone Data: SFY 2008-09•LIP Report FHURS Data: SFY 2006-07

•Eligibility, Enrollment, and Retention•Provider Participation/ Network Adequacy•Cost, Utilization and Efficiency•Delivery System Organization and Financing

•Racial and Ethnic Disparities in Medicaid Eligibility Change and Unmet Health Needs (policy brief #31)•Racial and Ethnic Disparities in Health Service Use and Perceived Unmet Health Needs Among Florida Medicaid Beneficiaries, June 2005 (full report)

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

•Suicide Risk in the Florida Medicaid Population (policy brief #25)•Suicide Risk in the Florida Medicaid Population, January 2005 (full report)

•Quality and Outcomes of Care•Cost, Utilization and Efficiency

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Delivery System Organization and Financing

2008 Florida KidCare Evaluation Report (Evaluation Year 10)

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization and Efficiency










FL 2009 Annual Report

X X X X

FL

X X X

FL

X X

FL Description of benefitsX

FL

X X X

FL

X X X X X X X

FL

X X X X X X

•Eligibility, Enrollment, and Retention•Consumer Experience•Cost, Utilization and Efficiency•Delivery System Organization and Financing

Analysis of Expenditures Pre- and Post-Reform


Credit/Purchase & Call Center Update 2nd Quarter FY 2011/2012

•Provider Participation/ Network Adequacy•Cost, Utilization, and Efficiency


Evaluation of Florida’s Family Planning Waiver Program: Report on Cost Effectiveness During Demonstration Year 9, 2006-07, Using Required CMS Methodology

•Eligibility, Enrollment, and Retention•Quality and Outcomes of Care•Cost, Utilization and Efficiency

Evaluation of Florida’s Medicaid Managed Mental Health Plans: Year 8 Report, June 2005

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/ Network Adequacy•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization and Efficiency•Delivery System Organization and Financing

Final Report of Evaluating Florida’s Medicaid Reform Demonstration Pilot, December 2011

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization and Efficiency•Delivery System Organization and Financing










FL

X X X

FLX

FL

X X X X

FL

X X X X

FL

X X X X X

First annual report: Evaluating Achievement of Program Objectives, 2007 Florida Medicaid Family Planning Waiver Program

•Eligibility, Enrollment, and Retention•Quality and Outcomes of Care•Cost, Utilization and Efficiency

Florida KidCare StatewideEnrollment Trend


Florida Medicaid Maternal and Child Health Status Indicators Report 2003-2007

•Eligibility, Enrollment, and Retention•Access to Care•Quality and Outcomes of Care•Cost, Utilization, and Efficiency

Florida MedicaidAdult Enrollee Satisfaction:A Chartbook

•Eligibility, Enrollment, and Retention•Consumer Experience•Quality and Outcomes of Care•Delivery System Organization and Financing

Longitudinal Study Report Baseline •Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization and Efficiency•Delivery System Organization and Financing










FL

X X

FL

X X X

FL

X X X X

FL Qualitative Studies Summary Report

X X X X X

FL

X X

GA

X X

Medicaid Prescribed Drug Spending Control Program Initiatives Quarterly Report - September & December 2010


Organizational Analyses Report•July 2006-March 2007•April 2008-March 2009

•Eligibility, Enrollment, and Retention•Provider Participation/ Network Adequacy•Delivery System Organization and Financing

Program For All-Inclusive Care For Children – 2009 Partners In Care Annual Evaluation Report (Evaluation Year 3)

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Cost, Utilization and Efficiency

•Access to Care•Provider Participation/ Network Adequacy•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization and Efficiency

Report on the Organization and Formation of Managed Care Organizations


•Analyses of Claims Submitted by Hospital Providers to Georgia Care Management Organizations

•Assessment of Physician Claims

•Georgia Families Program Dental Services Claims

•Provider Participation/Network Adequacy•Program Integrity










GA

X X

GA 2011 Single Audit Report Program IntegrityX

GA Quality and Outcomes of CareX

GA

X X

GA Program IntegrityX

GA CMO Performance and Oversight Update

X X X X

GA Program IntegrityX

GA EQRO Annual ReportsX X

GA Access to CareX

GA HS & R ReportsX

GA Program Integrity

X

GA Member Dental Survey

X X

•Analysis of Medicaid and PeachCare for Kids Dental Services Capacity

•Analysis of Dental Provider Networks

•Georgia Families Dental Application Analysis


Calendar year 2008 HEDIS Performance Measure Report

Care Management Organization (CMO) Flash Report


Care Management Organizations Cash Disbursement Journal Sample Validation

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Delivery System Organization and Financing

Encounter Data Validation Study Final Report


Georgia Families Dental Appointment Analysis


Medicaid Care Management Organization Act Compliance Monitoring Reports











HI 2005 Act 4 Medicaid Prescription Drugs

X X

HI

X X

HI 2008 Act 158 Section 4(19) SCHIPX

HI Cost, Utilization, and Efficiency

X

HIX X

HIX X

HIX X

HI 2011 Hawaii Provider Survey Report

X

HIX


2006 Act 160 Section 8 (20) Section 168.4 QUEST-ACE



2011 Act 92 SLH 2007 Immunosuppressant Medications Report

2011 Aggregate Consumer Guide Report for the QUEST Expanded Access Health Plans

•Consumer Experience•Quality and Outcomes of Care

2011 Aggregate Consumer Guide Report for the QUEST Health Plans


2011 External Quality Review Report of Results for the QUEST and QUEST Expanded Access Health Plans



2011 HCR199 HD1 Dual QUEST and Private Recipients Report











HI

X X X


X

HI 2012 Quest EnrollmentX


X

HI Cost, Utilization, and EfficiencyX

HIX X

HI DHS Annual Report 2011

X X X X

2011 Section 103F-107 HRS Medicaid Contracts

•Cost, Utilization, and Efficiency•Program Integrity•Delivery System Organization and Financing

2011 Section 346-59.9 HRS Psychotropic Medication Report


Act 200 Section 36 (Prescription Drugs for Fee-for-Service Clients)

Act 41 Section 38.1 (Payments made to DOH Adult Mental Health Division)

Aggregate QUEST Consumer Guide - Satisfaction Survey and Quality Measures by HSAG


•Eligibility, Enrollment, and Retention•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Program Integrity










HI FY2011 Audit Report

X X X

HI

X X X X X

HI

X X X

•Provider Participation/ Network Adequacy•Cost, Utilization, and Efficiency•Program Integrity

Hawaii QUEST ExpandedSection 1115 Draft Annual Report

•Eligibility, Enrollment, and Retention•Provider Participation/ Network Adequacy•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency

Report on SCR 106 Delayed Payments to DD/MR Providers

•Provider Participation/ Network Adequacy•Cost, Utilization, and Efficiency•Program Integrity










IA

X X

IA

X X

IA Hawk-I Annual Report

X

IA Hospital Readmissions Cost, Utilization, and Efficiency

X

IA Program Integrity

X

IA

X X X

IA

X X

IA Iowa Medicaid Update

X X

IA Medicaid Overview SFY 2011

X X

Annual Report of the Hawk-I BoardTo the Governor, General Assembly andCouncil on Human Services


B-1 Monthly Report of Medical Services Provided under Title XIX of the Social Security Act


•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy

Iowa Medicaid Drug Utilization Review Commission Annual Report of Activities

Iowa Medicaid Enterprise (IME) Performance Report - SFY 2007

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Program Integrity

Iowa Medicaid Enterprise (IME) Quarterly Reports













IA Monthly Medicaid Forecast

X

IA

X X

ID Delays in Medicaid Claims Processing

X X

IDX X

ID Feb. 2012 Legislative Report

X

ID

X X

ID Molina Status Report

X

ID Waiver Utilization Cost, Utilization, and Efficiency

X

ILX X

IL Enrollment

X X

IL HEDIS 2010 Medicaid RatesX X


Presentation by the Department of Human Services to Medicaid Elderly Waiver Interim Study Committee


•Consumer Experience•Cost, Utilization, and Efficiency

Delays in MedicaidClaims Processing, Follow-Up Report

•Provider Participation/ Network Adequacy•Consumer Experience


Medical Assistance Services, Idaho Legislative Budget Book



2009-2010 External Quality Review Technical Report













IL

X X X X

IL

X X X

IN

X X X X X X

KS

X X X

KS

X

Medicaid Managed Care Task Force Final Report

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Program Audit of the Covering All Kids Health Insurance Program

•Eligibility, Enrollment, and Retention•Cost, Utilization, and Efficiency•Program Integrity

Independent Evaluation of Indiana's CHIP -- Full report


•Child SCHIP Results 2009-2011•Child Medicaid Results 2009-2011


•Market price index comparisons: Medicaid vs. SEHP•Insurance mandates•Insurance premiums and market characteristics •Provider payments•Beneficiary expenditures•Membership and demographics•Medical trends and utilization

•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency










KS Program Integrity

X

KS

X X X X X X

KS

X X X

KS

X X X X

•Performance Audit of DHCF’s Oversight of Medicaid Managed Care Entities•Performance Audit of KHPA’s Medicaid Provider Enrollment and Terminations•Performance Audit of KHPA's Medicaid Pharmacy Program•Performance Audit of KHPA's Medicaid Contract Award Process•Performance Audit of Kansas’ Medicaid Claims Processing•Performance Audit of the Medicaid Home Health Fee-for-Service Program

2008 Medicaid Transformation plan: HealthConnect Kansas (statewide primary care case management program)

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Consumer Experience•Cost, Utilization and Efficiency•Delivery System Organization and Financing

2008 Medicaid Transformation plan: HealthWave (managed care program through which two populations, HealthWave Title XIX (traditional Medicaid) and HealthWave Title XXI (State Children’s Health Insurance Program [SCHIP]) receive health care services)

•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

2009 Reviews/Evaluations Published in 2010: HealthConnect











KS

X X X X X X X

KS Program IntegrityX

KS

X X X

KSX

KS

X X

KS Kansas Health Indicators

X X X X X

KS Medical Assistance Report (MAR)

X X

KS Provider Results TableX

2009 Reviews/Evaluations Published in 2010: HealthWave

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization & Financing

2009 Reviews/Evaluations Published in 2010:Surveillance and Utilization

Adult CAHPS Results 2009-2011 •Access to Care•Consumer Experience•Quality and Outcomes of Care

County Level Data Fiscal Year 2011 Eligibility, Enrollment, and Retention

HEDIS Cross Plan Comparison Table •Access to Care•Quality and Outcomes of Care

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Quality and Outcomes of Care•Cost, Utilization, and Efficiency












KS

X X

KY Cost, Utilization, and Efficiency

X

KY Characteristics of Beneficiaries

X

KY Eligibility Counts By County

X

KY Program IntegrityX

KY KCHIP Enrollment Data

X

KYX

LA

X

LA

X X

LAX

Reviews/Evaluations Posted in 2011:Quality Improvement


•Administrative Claims Data Report•Ambulatory Surgical Services Reports (ASC)•Home Health Services Reports (HHA) •Hospital Utilization and Services Reports•Long-Term Care Reports (LTC)•Kentucky Hospital Inpatient Data



Information Systems Can Help Prevent, but Not Eliminate, Health Care Fraud and Abuse


MS264 Reports Nov 2011 Eligibility, Enrollment, and Retention

•Children's Enrollment by Parish•LaCHIP Enrollment by Parish•Medicaid Eligible Children


2011 DHH LaCHIP Annual Report •Eligibility, Enrollment, and Retention•Cost, Utilization and Efficiency

2011 Louisiana Health Insurance Survey Eligibility, Enrollment, and Retention










LA Enrollment Trends Report

X X

LA

X X X X

LA Medicaid Enrollment by ParishX

MA Program Integrity

X

MA Massachusetts Health Care Cost Trends Cost, Utilization, and Efficiency

X

MA MassHealth HEDIS Report 2011 Quality and Outcomes of CareX

MA Program IntegrityX

MD

X

MD An Evaluation of the HealthChoice Program

X X X

MD Consumer MCO Report CardsX X

MD Cost, Utilization, and EfficiencyX


Medicaid Annual Report 2009/2010 •Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency•Delivery System Organization and Financing


DHCFP Fiscal Years 2007 and 2008 Annual Report

Ongoing Analysis of the Health Safety Net Trust Fund and Other Health Care Issues

•Money Follows the Individual Accountability Act Report•Report on the Living at Home Waiver Program•Report on the Home and Community-Based Long Term Care Services



•Consumer Experience•Delivery System Organization and Financing

Emergency Department Utilization by Medicaid Enrollees: Defining the Problem and Reviewing the Strategies










MD

X X

MD Maryland Medicaid eHealth Statistics

X X X

MD Maryland Medicaid Program Fact Sheets

X X X

MD Quality and Outcomes of Care

X

MD Quality and Outcomes of CareX

MDX

MD

X X




MD

X X

Final Report on Implementation of Medicaid Expansion to Parents and Their Children




Medicaid Managed Care Organization, Performance Improvement Projects, Cervical Cancer Screening Final Report 2008-2011

Medicaid Managed Care Organization, Performance Improvement Projects, Final Report 2011

Medical Day Care Report on Medical Eligibility Determinations


Report on Benefits Provided to Deaf and Hard of Hearing Children Through Medicaid/MCHP


Report on Implementation of Nursing Home Quality AssessmentReport on Long-Term Care Incentive Payments and Never EventsReport on the Impact of HIV Drug Co-Pays for HealthChoice EnrolleesReport to the General Assembly Dental Care Access Under Health Choice

•Access to Care•Provider Participation/Network Adequacy











ME

X X

ME Program Integrity

X

ME Procedure Payments for the Insured Tool Cost, Utilization, and EfficiencyX

MI Cost, Utilization, and Efficiency

X

MI

X X

MI

X X

MI

X X X

MI

X X X

MIX X

MI

X X

Study of the Financial Implications of the Pharmacy Carve-Out on the Maryland HealthChoice Program

MaineCare Children's Outpatient Mental Health Services- An Assessment of Administrative Costs and Their Drivers


MaineCare Durable Medical Equipment and Medical Supplies- Measures to Control Costs Need Strengthening

2010-2011 Coordination of Care/Medical Services Utilization Focused Study Report

2010-2011 External Quality Review Technical Report


2011 Michigan Consumer Assessment of Healthcare Providers and Systems (CAHPS)

•Eligibility, Enrollment, and Retention•Consumer Experience

A Guide to Michigan Health Plans Quality Checkup January 2012


Department of Community Health Audit of the Medicaid Home Help Program


External Quality Review Technical Report for Medicaid Health Plans


Follow-Up Audit of the MI Choice Home and Community Based Services Waiver for the Elderly and Disabled











MI Medicaid Blood Lead Testing Quality and Outcomes of CareX

MI Medicaid Health Plan EnrolleesX

MI

X X

MN

X X X

MN

X X

MN Consumer Experience

X

MN

X X X X


Michigan Medicaid HEDIS 2011 Results Statewide Aggregate Report


•Infant Mortality Among Births Covered by Minnesota Health Care Programs•Comparison of Low Birth Weight Outcomes among Medicaid and Non-Medicaid Funded Births in Minnesota


•Minnesota Health Care Programs Fact Sheet•Minnesota Family Planning Program Fact Sheet


2010 Managed Care Public Programs Consumer Satisfaction Survey Results

Critical Access Dental Program. Results and Recommendations, Minnesota Health Care Programs, Report to the Legislature

•Access to Care•Provider Participation/Network Adequacy•Consumer Experience•Delivery System Organization and Financing










MN

X X X X X

MN Enrollment Report, April 2008

X X

MN

X

MN

X

MN Quality and Outcomes of Care

X

MN

X

MN Managed Care Enrollment Figures

X

MN Consumer ExperienceX

MN

X X X

Disparities and Barriers to Utilization among Minnesota Health Care Program Enrollees

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency

•Eligibility, Enrollment, and Retention•Delivery System Organizing and Financing

Family Self Sufficiency and Health Care Program Statistics Available Through February 2012


Final Report to the Legislature: Compilation of Findings on Provider Rate Evaluations and Availability of Services in the Medicaid Fee-for-Service Program


Health Care Disparities Report for Minnesota Health Care Programs

Improving Access to Minnesota Health Care Programs for Hispanic/Latino Communities



Medicaid and MinnesotaCare Satisfaction Survey Results

Medicaid Home and Community Based Waiver Programs











MN

X

MN Medical Programs Annual Payments

X X

MN

X X X

MN Cost, Utilization, and Efficiency

X

MN

X X X

Medical Programs (including MNCare) eligibility



MHCP Racial Disparities in Healthcare Utilization Monitoring Report


Minnesota Medical Assistance Nursing Facility Recipient Rates

Minnesota Behavioral Health Treatment Need Assessment: Comparisons of Health Plans Participating in the Prepaid Medical Assistance Program

•Consumer Experience

•Quality and Outcomes of Care

•Cost, Utilization, and Efficiency










MN

X X X

MN Cost, Utilization, and Efficiency

X

MN

X X

MN

X X X

Minnesota Behavioral Health Treatment Need Assessment: Progam Level Analysis




Lead Poisoning in Minnesota Medicaid Children 1993-2003

Barriers to Preventive Care for Children Covered by Publicly Funded Health Care Programs in Minnesota



Perspective of Dentists and Enrollees on Dental Care under Minnesota Health Care Programs 2002

•Access to Care

•Provider Participation/Network Adequacy











MN

X X X

MN

X X X


X

MN

X X

MN MSHO Enrollment Charts

X

Dental Access for Minnesota Health Care Programs Beneficiaries, Report to the Legislature 2001

•Access to Care

•Provider Participation/Network Adequacy

•Cost, Utilization, and Experience

Disparities and Barriers to Utilization among Minnesota Health Care Program Enrollees

•Access to Care


•Cost, Utilization, and Experience

Disparities in Minnesota Health Care Programs: Focus Groups with Communities

Report to the Legislature: Home Care Reimbursement

•Eligibility, Enrollment, and Retention•Delivery System Organizing and Financing











MN

X X X


X

MN

X X

2000 Medical Assistance Health Plan Survey of Nursing Home Residents and their Families

•Access to Care



Medical Assistance Health Plan Survey. A Survey of Family Members of Nursing Home Residents Enrolled in the Minnesota Senior Health Options (MSHO) and the Prepaid Medical Assitance Program (PMAP)

Minnesota Senior Health Options (MSHO) Care Coordination Study Final Report

•Eligibility, Enrollment, and Retention

•Delivery System Organization and Financing











X

MO

X X X X X

MOX

MO

X X

MO Managed Care Cost Avoidance Model Cost, Utilization, and Efficiency

X X

MO MO HealthNet Clinical Services Report Cost, Utilization, and Efficiency

X

2002 Consumer Assessment of Health Care. MSHO Nursing Home Population.

Comparative Analysis of Quality of Care and Access to Services in MO HealthNet Managed Care and MO HealthNet Fee-for-Service

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Consumer Experience•Quality and Outcomes of Care•Delivery System Organization and Financing

Family Support Division Annual Data Report


Family Support Division, MO HealthNet Division, Monthly Management Report











MO

X X

MO MO HealthNet Medicaid Pharmacy Report Cost, Utilization, and EfficiencyX

MO Cost, Utilization, and EfficiencyX

MO MO HealthNet Program Integrity Report Program IntegrityX

MO

X X

MO Socio-Economic Fact Sheets

X X

MS 2009 General PresentationX

MS Annual Report Cost, Utilization, and EfficiencyX

MS Birth Statistics for Mississippi Medicaid

X X

MTX

MT

X X

MT

X X

MT DPHHS Program Statistics

X X

MO HealthNet High-Cost Beneficiaries Report


MO HealthNet Non-Emergency Medical Transportation Final Report

Quick Facts About Department of Social Services, MO HealthNet





•Monthly Enrollments (Medicaid)•Quarterly Enrollments (Medicaid)•HMK Eligibility Summary


Charts of the week •Eligibility, Enrollment, and Retention•Cost, Utilization, and Efficiency

Description of Medicaid Managed and Programs Implemented by DHHS

•Cost, Utilization, and Efficiency•Delivery System Organization and Financing











MT Medicaid Brochure 2010

X X

MT Medicaid Enrollment by County/CityX

MT Cost, Utilization, and EfficiencyX

MT Medicaid Statistics

X X

NC Active Eligibility Case Loads Counts

X

NC

X X

NC

X

NC

X X



Medicaid Long-Term Care Expenditure Study

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy


Appeals Process for Medicaid Applicants and Recipients

•Consumer Experience•Program Integrity

Authorized Medicaid and Health Choice for Children Eligibles Reports


Blue Ribbon Commission on Medicaid Reform











NC

X X

NC Access to Care

X

NC

X X

NC Cost, Utilization, and Efficiency

X

NC

X X X

NC Program Integrity

X

CCNC/CA Medicaid Monthly Dual Eligible Reports, CCNC/CA Medicaid Monthly Enrollment Reports, CCNC/CA Medicaid Monthly Exemption Reports


Children's Health Care Coverage, Comparison of Children Insured Through Medicaid and NC Health Choice

Community Care of North Carolina Performance Measures


Controlling the Cost of Medicaid Private Duty Nursing Services, Final Report to the Joint Legislative Program Evaluation Oversight Committee

County Specific Snapshots for NC Medicaid Services


Department of Health and Human Services Legislative Report, Appeals Process for Medicaid Community Support Providers










NC DMA Dashboard Measures

X X

NC DMA HEDIS Data Tables

X X


X

NC Health Check Participation Data

X X

NC Quality and Outcomes of Care

X

NC Medicaid Annual Report

X X X X

NC Medicaid Financial Dashboard

X X X



Enhanced Services Package Implementation: Costs, Administrative Decision Making, and Agency Leadership


Legislative Report on CCNC Performance Measures


•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency










NC Medicaid Overview

X X


X

NC

X X

NC

X X

NC PI Management Report Program Integrity

X


Mental Health Drug Management Program Reports

NC Health Choice Annual Reports, Utilization Statistics


North Carolina Medicaid Be Smart Family Planning Waiver Annual Report











NC

X X X

NC

X X

NC

X X X X


X

NC Study HIV Waiver Cost, Utilization, and Efficiency

X

NC

X X

NC

X X

Pilot Project to Evaluate the Use of Home Telemonitoring Equipment for Home and Community Based Medicaid Recipients

•Provider Participation/Network Adequacy•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency

Piloting Integrated Care via Dual Eligible Special Needs Plan

•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Quality Strategy for the Piedmont Behavioral Healthcare Prepaid Inpatient HealthCare Plan and Innovations Waiver


Report on the Effectiveness of the Length of Stay Limitation and the Number of Children Staying in Level II, III, and IV Facilities

Asthma Collaborative Evaluation- State Center for Health Statistics



Effect of NC Open Access Collaborative on Medicaid Utilization and Costs for Children in Primary Care Practices












NC

X X

ND

X X

ND Biennial Medicaid Report

X X X

ND Human Services

X X

ND Cost, Utilization, and EfficiencyX


ND

X X

ND Quarterly Budget Insight ReportX

NDX



Use of Preventive Health Services by Children With Special Health Care Needs Enrolled in Medicaid in North Carolina



•Medicaid General Info, Covered Services•Medicaid Waiver for Home and Community Based Services•Fact Sheet Home and Community Based Services




Medical Services, Long-Term Care Services, and Healthy Steps

National Trends in Long-Term Care Services

North Dakota Medical Services 2004 Medicaid Customer Service Survey



State Fiscal Year 2011: Unduplicated Count Report for Economic Assistance Programs


Testimony before the Health and Human Services Committee

Testimony of Department of Human Services to Industry, Business, and Labor Committee










NE Charts and Graphs

X X

NE Consumer ExperienceX

NE Nebraska Medicaid Annual Report

X X

NE Nebraska Medicaid EligiblesX

NE

X X

NE

X X X

NH

X X X


Children's Behavioral Health Oversight Committee Report to the Governor and Legislature

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency


Nebraska Medicaid Expenditures and Eligibility Changes from SFY 2004 to SFY 2005


The Nebraska Medicaid Program's Collection of Improper Payments


•Comparison of Primary Care Received by NH Medicaid Members at Difference Practice Settings Report•Depression Among NH Medicaid Members•Frequent Outpatient Emergency Department Use by NH Medicaid Members•Preventative Health Care Services Provided to the NH Medicaid Adult Population•Comparison of Prevalence, Utilization, and Payments for Chronic Respiratory Diseases











NH

X X X X

NH Health Plan Performance Summary Report Access to Care

X

NH Medicaid Annual Report

X X X X

NJ Program Integrity

X


X


X

NJ

X X

NJ

X X

NJ

X

NJ Enrollment by CountyX

Children's Health Insurance Programs in New Hampshire



Department of Health and Senior Services Division of Consumer Support Medical Assistance to the Aged Medical Day Care Program

Department of Health and Senior Services Division of Senior Benefits and Utilization Management Medical Services for the Aged Nursing Homes

Department of Human Services Division of Medical Assistance and Health Services Durable Medical Equipment and Supplies

Department of Human Services Division of Medical Assistance and Health Services Eligibility Determination

•Eligibility, Enrollment, and Retention•Program Integrity

Department of Human Services Division of Medical Assistance and Health Services Health Benefits Coordinator Contract for the NJ FamilyCare Program


Department of Human Services Division of Medical Assistance and Health Services Managed Care Provider Networks












NJ HMO Performance Report

X X X X X X

NJ Monthly Enrollment ReportsX

NJX

NJ

X X

NM Program Integrity

X


X



NJ FamilyCare Outreach, Enrollment, and Retention Report


Department of Human Services Division of Medical Assistance and Health Services Health Benefits Coordinator Contract for Medicaid Managed Care Programs


•Behavioral Health Performance Measurement/Performance Improvement Project Audit Report•CoLTS Performance Measures/Performance Improvement Project Audit

•Behavioral Health Utilization Review Denial Audit•Physical Health Utilization Review Denial Audit










NM

X X X


X

NM

X X

NM Behavioral Health Compliance Audit Program IntegrityX

•Coordination of Long-Term Services (CoLTS) Program Fact Sheet•Who is enrolled in CoLTS


•Cross Validation Audit of Physical Health Encounter Data•Cross Validation Audit of Behavioral Health Encounter Data

Assessment of Access to Care and Quality of Care for Children With Asthma and Adults With Diabetes











NM Breast and Cervical Cancer Program Cost, Utilization, and Efficiency

X

NM CoLTS Compliance Audit Program IntegrityX

NM Consumer Satisfaction Surveys

X X X X

NM Eligibility Reports

X

NM ER Report

X X X

NM

X X

•Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency



FY10 Medicaid Spending, Enrollment and Cost per Client











NM HEDIS Reports

X X X X X X

NM Independent Assessment Behavioral Health

X X X X X X X

NM Independent Assessment CoLTS

X X X X X X


•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Program Integrity

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Consumer Experience•Program Integrity•Delivery System Organization and Financing










NM Independent Assessment SALUD

X X X X X X

NM Program IntegrityX

NM PCO Program Background Cost, Utilization, and Efficiency

X

NM Physical Health Compliance Audit Program IntegrityX

NM Program IntegrityX

NM Program Integrity Audit Program IntegrityX

NM Report to the Legislative Finance Committee

X X

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Program Integrity

Managed Care Performance Evaluation Report

Physical Health Performance Measurement/Performance Improvement Project Audit











NM

X X X X X

NV

X X

NV Cost, Utilization, and Efficiency

X

NV Annual Drug Utilization Review Report Cost, Utilization, and Efficiency

X

NV

X

NV Enrollment Statistics

X X

NV FY10 BH Ped Comprehensive

X X X

SCHIP Waiver Analysis and Evaluation Final Report Revised

•Eligibility, Enrollment, and Retention•Access to Care•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

•DHCF Home and Community Based Waiver for Persons with Physical Disabilities Caseload•Mental Health and Development Services Caseload


•Monthly OOS RTC Placement Reports•Quarterly OOS RTC Replacement Reports•OOS RTC Placement-Trend Report

Budget and Statistics- Caseload Statistical Data













NV Medicaid and Nevada Check Up Fact Book

X X

NV Nevada Behavioral Health Utilization

X X X

NV

X X

NV

X X X

NY

X X

NY

X X X X

NY Quality and Outcomes of Care

X

NY Quality and Outcomes of CareX



Nevada Medicaid and Nevada Check Up Update


Nevada's 2012- 2013 Quality Assessment and performance Improvement Strategy


A Comparison of Potentially Preventable Hospital Readmissions where Preceding Admission was a Behavioral Health, Medical, or Surgical Admission


All Plan Summary Report for New York State Medicaid Managed Care Organizations


Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis

Demographic Variation in Medicaid Managed Care










NY Quality and Outcomes of Care

X

NY Cost, Utilization, and Efficiency

X

NY HIV Special Needs Plan Summary Reports

X X X X X X

NY

X X

NY

X X X

eQARR (Quality Assurance Reporting Requirements) Interactive Report

Evaluation of NY's HIV Special Needs Program: Cost and Usage Impacts

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Hospital Admissions for Ambulatory Sensitive Conditions and Subsequent Potentially Preventable Readmissions in the Medicaid Population in New York State


Managed Care Plan Access and Utilization Report

•Access to Care•Quality and Outcomes of Care•Cost, Utilization, and Efficiency










NY

X

NY Managed Care Regional Consumer Guides

X X

NY

X

NY

X


X

NY Medicaid Managed Care Satisfaction Survey Consumer Experience

X


X

NYX

Managed Care Plan Enrollment by Health Plan and County



Managed Long Term Care Plan Member Satisfaction Survey Report

Medicaid Eligibles and Expenditures by County (excel files)


Medicaid Eligibles and Expenditures by County (excel files)

Medicaid quarterly reports by beneficiaries, expenditures, units of service by category of service by aid category by region

Monthly Medicaid Managed Care Enrollment Report











NY

X X

NY

X X

NY

X X

NY

X X

NY

X X

NY

X X X

New York State Managed Care Plan Performance Report

•Eligibility, Enrollment, and Retention•Quality and Outcomes of Care

Potentially Avoidable Hospitalizations: New York State Medicaid Program, 2009


Potentially Preventable Hospital Readmission Among Medicaid Recipients with Mental Health or Substance Abuse Health Conditions Compared to All Others


Potentially Preventable Hospital Readmission Among Medicaid Recipients: New York State, 2007


Regional Variation in Children's Myringotomy Rates, New York State Medicaid Program, 2008


Survey of SSI Medicaid Managed Care Enrollees, NYC

•Access to Care•Provider Participation/Network Adequacy•Consumer Experience










NY

X X X X

OH

X X

OH

X X

OH Eligibility Data Reports

X X

OHX

OH Expenditures

X X X

OH

X X X X

Utilization of Hospital Inpatient Services by Fee-for-Service and Managed Care Medicaid Recipients New York State, 2007

•Eligibility, Enrollment, and Retention•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Annual Report of the Medicaid Buy-In for Workers with Disabilities


Customer Satisfaction Survey Overview, 2010 Ohio Aged, Blind, or Disabled Medicaid Managed Care Program Member Satisfaction Survey, 2010 CAHPS Ohio's Covered Families and Children Medicaid Managed Care Program



Enrollment Report for Medicaid Buy in for Workers with Disabilities

Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Home and Community Based Waivers Administered by the Ohio Department of Aging Ongoing Review

•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Program Integrity










OH

X X X X X X X

OH

X X

OH Quality and Outcomes of Care

X

OH

X X X X X X X

OH

X X X X

OH

X X

OH Semi-Annual Prompt Pay ReportX

Individual Options Waiver A Comprehensive Review

•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Program IntegrityMedicaid Managed Care Monthly

Enrollment Reports•Eligibility, Enrollment, and Retention•Delivery System Organization and Financing

Medicaid Managed Health Care Clinical Performance Measures

Medicaid Managed Health Care Statewide Progress Reports

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Ohio Home Care and Transitions Developmental Disabilities Waivers

•Access to Care•Consumer Experience•Quality and Outcomes of Care•Program Integrity

Quarterly Cost Management Report on Ohio's Medicaid Program












OK

X X

OK

X

OKX X

OK Annual DeliveriesX

OK Behavioral Health Fast Facts

X X X

OK Certified Nurse Aide Training Program

X X

OKX X

OK Cost, Utilization, and EfficiencyX

OK

X X X X X X

OK Focus on Excellence

X X

•Provider Fast Facts•Provider Fast Facts by County

•Provider Participation/Network Adequacy•Quality and Outcomes of Care

•Total Enrollment, Total Enrollment by County•SoonerCare Children•SoonerCare Adult•Children Under 18 By Race & County


Adult Medical Health Care Services (CAHPS) Survey


Eligibility, Enrollment, and Retention•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency

•Provider Participation/Network Adequacy•Delivery System Organization & Financing

Child Medical Health Care Services (CAHPS) Survey


ER Utilization and ER Utilization Persistent Population QuarterlyEvaluation of SoonerCare Choice – PDF Full Report

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

•Provider Participation/Network Adequacy•Delivery System Organization & Financing










OK Quality and Outcomes of CareX

OK

X X X

OK SoonerCare Choice

X X

OK

X X

OK

X X X

OK TEFRA

X X

OK

X X X X X X X

OR

X X

ORX X

Minding Our P's and Q's, The OHCA Performance and Quality Report

PACE (Program of All-Inclusive Care for the Elderly)

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Delivery System Organization & Financing


SoonerCare Home and Community-Based ServicesFast Facts


State Fiscal Year 2011: Oklahomans Working for Oklahomans, Annual Report SFY 2011

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency•Program Integrity


Various SoonerCare surveys, studies, and reports

•Eligibility, Enrollment, and Retention•Access to Care•Provider Participation/Network Adequacy•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

•Capitation Rate Development Reports•Expected Per Capita Cost Reports

•Cost, Utilization, and Efficiency•Delivery System Organization & Financing

2008 CAHPS Health Plan Survey, Adult Medicaid Sponsor Report











OR 2009 Physician Workforce Survey

X

OR OHP Demographic ReportsX

OR OHP Eligibility ReportsX

OR OHP Managed Care Enrollment Reports

X X

PA Quality and Outcomes of Care

X

PA 2010 PA Statewide BBA Report Quality and Outcomes of CareX

PA

X X

PA Enrollment FiguresX

PAX



Eligibility, Enrollment, and Retention•Eligibility, Enrollment, and Retention•Delivery System Organization and Financing

•HealthChoices Performance Trending Report 2011•Rate Charts and Quality Measures•Five Year P4P Evaluation

Access Plus and HealthChoices CAHPS Measures



MA, TANF, GA, SNAP, & CHIP data-Mar. 2012











PA

X X X X

Medical Assistance for Children with Disabilities 2007 Report

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency•Delivery System Organization & Financing










PA

X X X X X

RI

X X

Office of Medical Assistance Programs Annual Report 2009-10

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Behavioral Health Hospital and Emergency Department Utilization: Fee-for-Service Medicaid Recipients, Calendar Year 2000












RI

X X

RI

X X X X

RI 2007 RIte Care Member Satisfaction Survey

X

RI

X X X

Hospital and Emergency Department Utilization for Working-Age Rhode Islanders on Fee-for-Service Medicaid 1998-2000



Needs Assessment Survey of Rhode Island Working-Age Adults with Physical Disabilities and Chronic Health Conditions on Fee-For-Service Medicaid (Full Report) (Executive Summary)


•Access to Care




Awareness of and Need for Home and Community Based Services for Rhode Island Adults on Medicaid, Snapshot Survey Results

•Access to Care•Consumer Experience•Delivery System Organization and Financing










RI

X X

RI

X X

RI

X X X

RI Cost, Utilization, and Efficiency

X

RI

X

RI Quality and Outcomes of Care

X

RI RI Annual Medicaid Expenditure Report

X X X X

Change in the Characteristics of Rhode Island Medicaid Population in Nursing Homes 2008 - 2010

•Quality and Outcomes of Care•Delivery System Organization and Financing

Characteristics of the 2008 RI Medicaid Population in Nursing Homes

•Quality and Outcomes of Care•Delivery System Organization and Financing

Designated Medicaid Information Report to RI Senate


Estimated Savings in the RIte Share Program

Long Term Services and Supports Resource Mapping, Final Report, Hilltop Institute


Monitoring Quality and Access in Rite Care & Rhody Health Partners

•Eligibility, Enrollment, and Retention•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization and Financing










RI Rite Care and Rite Share Issue Brief

X X

RI RIte Care/RIte Share Annual Report

X X X X X

RI Quality and Outcomes of CareX

RI

X X

SC

X X

SC

X X X X

SC

X X X X

SC Program Integrity

X


•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency

The Impact of RIte Care on the Health of Pregnant Women and Their Newborns 1993 – 2004

Value Purchasing for Home and Community Based Services


Enrollment Map, Enrollment Snapshot (from dashboard), and Eligibles and Enrolled Members by County


Medicaid Cost and Quality Effectiveness Report (this is a combined PDF of several different reports)

•Eligibility, Enrollment, and Retention•Consumer Experience•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Medicaid Cost and Quality Effectiveness Report (this is a combined PDF of several different reports)

•Eligibility, Enrollment, and Retention•Consumer Experience•Cost, Utilization, and Efficiency•Delivery System Organization and Financing

Medicaid Provider Fraud Report for Provison 21.37










SCX X

SD

X X

SD

X

SD Cost, Utilization, and Efficiency

X

TN

X X

TN Enrollment Data, November 2011X

TN HEDIS/CAHPS Report

X X X

TN

X X X

TN TennCare Oversight

X X X

TN

X X X

TNX X

TN Women's Health Report 2008

X X

Report of the Medicaid Transportation Advisory Committee

•Consumer Experience•Cost, Utilization, and Efficiency

•Annual Statistical Report•Monthly Statistical Analysis Reports


•Number of People Eligible for Medical Assistance•Number of People Eligible for Managed Care


•PMPM Eligibility Category, Budget Activity•PMPM Specific Medical Categories•Emergency Room Claim Data

Actuarial Review of the TennCare and TennCare Partners Program


Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care

Report to Legislative Committees April 13, 2012


•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Delivery System Organization & Financing

TennCare's Fiscal Year 08-09 Annual Report

•Eligibility, Enrollment, and Retention•Cost, Utilization, and Efficiency•Delivery System Organization & Financing

The Impact of TennCare, A Survey of Recipients 2011












TX

X

TX

X X

TX Program IntegrityX

TX Medicaid Timeliness ReportsX

TX Monthly Confirmed Eligibles Report

X X

TX Physical Health Provider Office Survey

X

TX Cost, Utilization, and Efficiency

X

TX

X X X

TX

X X X

TX

X X X

•CHIP enrollment statistics•Medicaid enrollment statistics•Women's health program enrollment statistics


CHIP Quality of Care Measures FY2008 •Access to Care•Quality and Outcomes of Care

Medicaid Error Rate Report for Federal Fiscal Years 2009-2011



Potentially Preventable Readmissions in the Texas Medicaid Population, Fiscal Year 2010 - January 2012

Texas Medicaid and CHIP in Perspective, Eighth Edition (Pink Book)


Texas Medicaid Managed Care STAR + PLUS Quality of Care Report


Texas Medicaid Primary Care Case Management (PCCM) Program Quality of Care Report











TX

X X X

TX

X X

TX

X X

UT

X X X X

UT

X X

UT CHIP Annual Report

X X

UT Medicaid Annual Report

X X X X

UT Program Integrity

X

Texas Medicaid STAR Health Program Quality of Care Report


Texas STAR Managed Care Organization and Primary Care Case Management --Adult Enrollee CAHPS Health Plan Survey Report


Texas STAR Managed Care Organization and Primary Care Case Management --Child Enrollee CAHPS Health Plan Survey Report


Utah Health Plan Quality of Care Report (HEDIS)

•Eligibility, Enrollment, and Retention•Access to Care•Quality and Outcomes of Care•Delivery System Organization and Financing

Utah Health Plan Satisfaction Report (CAHPS)


•Eligibility, Enrollment, and Retention•Quality and Outcomes of Care

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization and Efficiency•Delivery System Organization and Financing

Office of Inspector General of Medicaid Services Annual Report










UT

X X

UT Medicaid Optional Services

X X

VA Adult CAHPS Fee-for-Service

X X

VA Children CAHPS Fee-for-Service

X X

VA Annual Technical Report

X X X

VA 2010 Birth Outcomes Focused Study Quality and Outcomes of Care

X

VA 2010 Child Health Focused Study Quality and Outcomes of Care

X

VA

X X

Utah Health Status Update: Who Does Medicaid Serve?






2011 Performance Report: Virginia Medicaid Managed Care Annual Report

•Consumer Experience•Delivery System Organization & Financing










VA

X

VA The Virginia Medicaid Program at a Glance

X X X

VT Budget DocumentX

VT Green Mountain Care Enrollment ReportsX

WA

X X

WA External Quality Report Annual Review

X X X X X X

WA

X X

WA

X X

WA Enrollment Figures for Medicaid Programs

X X

WA House Bill 2633 Working Session Program Integrity

X

Medicaid Waiver Services - Monthly Recipient

Delivery System Organization and Financing


•Scope of Coverage•Cost, Utilization and Efficiency


Performance Measure Comparative Analysis Report using Health Plan Employer Data and Information Set (HEDIS)


•Eligibility, Enrollment, and Retention•Access to Care•Consumer Experience•Quality and Outcomes of Care•Cost, Utilization, and Efficiency•Delivery System Organization & Financing

Consumer Assessment of Healthcare Providers and Systems (CAHPS)


•Americhoice Client Satisfaction Survey Results•King County Care Partners Client Satisfaction Survey Results












WI ForwardHealth Enrollment DataX

WI Monthly HMO Enrollment Reports

X X

WI Health Care Enrollment

X X

WIX X

WI 2009/2008--HMO Report CardX X

WI

X X X

WI An Evaluation: Medical Assistance Program

X X X

WI BadgerCare Plus Basic Plan

X X

WVX

WV Medicaid EligiblesX

WV MCO Monthly Enrollment

X X

WV Legislative interim reports: Medicaid Report Cost, Utilization, and EfficiencyX

WV Electronic Health Record (EHR) Incentive Quality and Outcomes of CareX

WV Program IntegrityX




Enrollee Satisfaction Survey Executive Summary Report



BadgerCare Plus Managed Care Quality Assurance Measures Final Report




•Current Enrollment Chart•Annual Enrollment Chart



West Virginia Medicaid Top 10 Claim Errors










WY Wyoming Medicaid Annual Report

X X X X X

WY Wyoming Medicaid Birth Report 2011

X

WY Wyoming Medicaid Eligibility Overview

X

WY Kid Care CHIPX

WY

X X

•Eligibility, Enrollment, and Retention•Provider Participation/Network Adequacy•Cost, Utilization, and Efficiency•Program Integrity•Delivery System Organization and Financing




Kid Care CHIP: Wyoming's State Children's Health Insurance Program


Measures Reported Data Breakdowns/ Subpopulations Most Recent Publication Year Frequency of Publication/Update

Medicaid eligibility for children in foster care 2009 Annually

DH&SS Current as of Spring 2012

2010 Annually

2011 Annually

2004 One time report

Current as of Spring 2012

Alaska vs. national Multiple data sources Current as of Spring 2012

Overall error rate relative to 17 states 2008 Every three years

Data Source or Document for Measures/Set of Measures

•Unduplicated recipients of Medicaid dental services•Provider participation (count)•Expenditures (total, fillings, root canals, dentures)•Services (fillings, root canals, dentures)

•Number of children served by out-of-state Residential Psychiatric Treatment Centers (RPTC)•Medicaid expenditures for out-of-state RPTC

•Overall (approximate) enrollment•Overall (approximate) spending as a percent of Department spending, description of cost saving due to specific initiatives

•Enrolled statistics•Utilization of services by type and per enrollee

Age, gender, geographic area, native status

Medicaid enrollment and claims data

•Allotment/allowable expenditures (federal, total, state match)•Disproportionate share payments, by hospital, unexpended

•Annual enrollment growth rate•Spending growth rate (total, ARRA Enhanced FMAP)

Review of Medicaid payments from 17 states to measure billing and eligibility related errors

Measures Reported Data Breakdowns/ Subpopulations Most Recent Publication Year Frequency of Publication/UpdateData Source or Document for Measures/Set of Measures

Medicaid vs. CHIP (for EPSDT) 2005 Annually


Total enrolled County, age, gender and race 2011 Monthly

Varies: 2010-2012 Annually

2010


•Number of users and costs of travel assistance (USTravel Medicaid)•Frequency of use of Fair Hearings, which was intended to lead to enrollment in Care Management Program (on hold at time of report)•Total number of calls per month and average wait time for Recipient Helpline•Number of EPSDT enrolled children and services provided

•State Medicaid expenditures•Annual Medicaid expenditure level per enrollee related to rest of country

These are examples as there is an entire statistical appendix. •Enrollment by eligibility group, eligibles monthly counts, eligibles as a percent of the population, percent of population eligible by county, cost per eligible, expenditures by type of service, identification of overpayments and recoupments.•Eligibility by aid category and county•Population, eligibles, and enrolled by county•Number of participating providers by provider type

Enrollment statistics broken down by gender, race, and age; at times by county

•Enrollment (total and growth, by program)•Reasons for case closures•Number and percent of children enrolled in ARKids First not assigned a primary care physician (by county)

•Number eligible (for Medicaid)•Number of recipients•Expenditures •Utilization (number of units and days per COS)•Actual Medicaid co-payments (dollars)•Medicaid Claims with co-payments (number of claims)•Medicaid/Medicare crossover expenditures (dollars)

•Eligibility Category•Category of Service

•Medicaid Management Information System (MMIS)•Eligibility System (County Operations System)



Waiver type 2010 Annually

2011 Annually

2012 Quarterly

2010

2004 Annually

•Set 1: expenditures (by primary diagnosis), for ICD-9 codes and procedure class•Set 2: expenditures (by CPT/HCPC codes)•Set 3: pharmacy expenditures (by HIC Code)•Set 4: expenditures (by provider type, specialty, and county)•Set 5: average monthly enrollment by eligibility category•Set 6: monthly enrollment (by age), hospital inpatient and outpatient payments (by primary diagnosis group), outpatient stratified by in- and out-of-state, other payments to providers (cost settlements, etc.)•Set 7: expenditures (by category of service), stratified by total expenditure amount•Set 8: sources and uses of Medicaid funds•Exhibit 20: Total expenditures for services (2010, by age group)

Primary diagnosis, ICD-9/CPT/HCPC/HIC code, procedure class, provider type/specialty, county, eligibility category, age, category of service, facility location (in- or out-of-state)

•Waiver population size•Compliance with waiver requirements (percent)

Chart reviews of a random sample of active case populations in each waiver category

•Number of enrollees, unduplicated beneficiaries, and population served•Expenditures (total claims payment and average per beneficiary claim payments)•Drug rebate collections (state and federal)•Program cost (total, per beneficiary)•Number of providers•Number of claims processed, approximate claims processing time•Long term care: number of patient days, number of unduplicated beneficiaries, total expenditures, average daily payment, and average per beneficiary payments•Average cost per prescription drug

County, aid category, wavier, service type, age

•Number of eligibles (monthly)•Number of recipients (monthly, age, eligibility category)•Expenditures (total, by type (prescription drugs, long-term care, hospital/medical), by category (more numerous)

•Expenditures (total, per unit provided, per unduplicated recipient)•Units provided (total, per unduplicated recipient)•Unduplicated recipients (total, per provider)•Providers by Tax ID•Unduplicated procedures, per recipient

Age, Community Mental Health Center (CMHC) vs. non-CMHC

•Average number of days from Medicaid receipt to adjudication•Percent of payments by electronic funds transfer (EFT)•Proportion of claims processes with EDI


Arkansas compared to other states 2010 One time report

One time report

2012 Annually, quarterly

Amounts paid by AHCCCS for services 2009 Annually

Managed care plan 2011

Managed care plan 2010 One time report

Plan Plan reported 2009 One time report

Plan, for both HMOs and dental plans 2007 One time report

Raw drug utilization data for all FFS outpatient drugs is available for download Claims data 2012 Monthly and Quarterly

•Expenditures (total, per capita, per enrollee, by category of service, amount of federal match, by county)•Measures of economic impact (economic activity, number of jobs attributable to Medicaid)

•ALTCS Survey- Satisfaction with LTC facilities, case managers, and caregivers. Satisfaction with transportation services, and program contractors. •AHCCCS Survey- Satisfaction with doctor or nurse, health care received, health plan, etc.•Provider Survey- claims procedures, satisfaction with communication and administrative requirements, translation services, etc.

•Managed care plan, place of residence (facility or community), geographic location•Provider survey- by provider type and location

Random sample phone interviews

ALTCS survey: 2008AHCCCS survey: 2006Provider survey: 2006

•Births•Enrollment

County, eligibility group, delivery system (FFS vs. Managed Care), AHCCCS vs. ALTCS, demographics

Health plan, Hospital for inpatient and outpatient stays, by nursing home, FQHC

•Sanctions imposed for inaccurate encounter data, marketing violations, and non-compliance with quality measures•Audited financial statements of managed care plans

Continuous for sanctions, annual for financial statements

•Performance measures such as lipid screening for diabetics or EPSDT participation.•Health plan compliance with administrative requirements such as case management load

Childhood immunization rates, well child visits, adolescent well care visits, children's access to PCP

Satisfaction with plan, overall rating of health care provided, satisfaction with doctor or nurse/dentist, ability to get needed care, how well doctors communicate

Survey conducted by mail an external company in 2007



BHO 2008 Annually, but only 2008 is posted




Claims data 2009 One time report


Medicaid and CHP+ Caseload Year 2011 One time report

•Enrollment data (as point in time estimates and trends)•Expenditures and Utilization•Births, and induced termination of pregnancy data•Top pharmacy dispensed drugs•Top medical conditions and mental health conditions

Validation of BHO performance including in meeting access to care requirements, coordination of care, data integration and data control processes, etc.

•Number enrolled and on waitlist by HCBS waiver, average caseload by agency•Timeliness of eligibility determination for long-term care services, •HCBS and nursing facility expenditures, HCBS expenditures and client count by service category

•Number of claims transaction errors and error rate (from a sample)•Damage assessments against Anthem•Timeliness of claims processing•Number of enrollees in case management (from a sample)

Claims data, data submitted by Anthem

•Number of enrolled children and pregnant women, average number of enrollees per health plan•Cost per enrollee, annual payments per health plan•HEDIS measures including: number of well child visits, access to primary care, asthma, number of children enrolled vs. number eligible

Some measures by year, some by health plan

HEDIS, claims data, enrollment data

•Payments in excess of allowable rates•Claims paid after date of death, number of claims paid not meeting medical necessity criteria •Total expenditures and number of claims for DME•Total expenditures and number of claims for laboratory and radiology services,

Expenditure and number of claims are by year

•Number of waiver participants •Average per-capita expenditures, average units of service used or dollars of service used by service type



County Annually

Some measures by year 2004 One time report

Disability status Inquiries sent to Ombudsman 2011 Annually




2011 Monthly

County, town, age, race/ethnicity 2012 Monthly

2007

•Number of children enrolled using waiver services •Average cost of waiver services per enrolled child•Total enrolled children, total expenditures, type of services received •Number of children not receiving services due to lack of providers•Number of providers participating in waiver program

•Prevention Quality Indicators, service utilization, costs•General information about the Medicaid Population

Prevention quality indicators: 2009Service utilization: 2012

•HMO Average Enrollment•Medicaid payments to HMOS, Average cost per enrollee, typical payment amounts by condition•Amount of overpayments in sample of claims, HMO payment correction amounts by type, number and amount for paid claims after client date of death.

•Number of complaints related to access to care, denial of benefits, and quality of care. •Client satisfaction with compliant process.

•Mental health capitation payments•Number of Medicaid members, number of individuals served•Number of services provided, number of BHO's using best practice standards. •Medical expenses by internal vs. external provider network, BHO per member per month rates, expenditures by type of service

Some measures by year, rates by eligibility category

Fiscal year data from the Department of Health Care Policy and Financing, BHO audited financial statements

•Outpatient substance abuse treatment client demographics and geographic distribution•Total costs for outpatient substance abuse benefits, average cost by client

•Payments for non-covered drugs, pricing errors•Amount of outstanding rebates, rebates as a percentage of total Medicaid drug expenditures, number of pharmacy overrides •Total FFS drug spending

•Total enrollment•Number of plan changes•Number of disenrollments•Number of new enrollments

County, coverage group, plan, town, age category, race/ethnicity

•Total enrollment•Number of plan changes•Number of disenrollments•Number of new enrollments

•Enrollment (total, <19 years old, by county, by program)•Number of applications (total, new, renewal)•Reasons for disenrollment (by plan)


Plan 2006

•Husky Enrollment (total and growth, monthly) Age 2008 Annually

2012

2012

•EPSDT enrollment Age, county 2009 Monthly

2012



2012

Husky enrollment database 2011

•Number of births (total, by town, by race, to teens, by timing of prenatal care)•Percent of women receiving early and adequate prenatal care•Maternal health (anemia, gestational diabetes, pregnancy-associated hypertension, previous preterm or low birth weight baby, smoking during pregnancy)•Percent delivering through cesarean section•Birth outcomes (birth weight category, preterm birth)

CT birth data, HUSKY A enrollment data, and FFS eligibility data

•Number of ASO calls (total, abandoned)•Number of emails to call center•ASO call speed of answer•ASO call average talk time•Most frequent reasons for calls•Number of referrals to DSS•Number of cases referred to Escalation Unit•Number of specialists located through escalation unit•Number of instances of type of assistance through Escalation Unit

•Spending per Medicare-Medicaid Eligible (MMEs, or dually-eligible), compared to Medicaid only•Percent enrollment attributed to MMEs

•Application activity (pending, new, resolved, renewal, referred to DSS, denied/closed)•Enrollment (total, by county, premium band)•Number who did not reapply at renewal•Disenrollment due to failure to pay premium

Program (Husky B, Charter Oak, and CT PCIP)

•Medicaid spending (per enrollee, case, and facility)•Proportion of Medicaid spending on hospital care•Percent in managed care vs. fee-for-service plans•Number of new enrollments

•Number of teens (12-21) receiving well-child or acute care visit•Number of teens with documented assessments for behavioral health problems, sexual activity

Qualidigm (external quality review contractor for Department of Social Services Medicaid Managed Care Program) Report

•Husky Enrollment (total, by age, by band), for Husky A (Medicaid) and Husky B (CHIP)•Retention ratio•Coverage Continuity (by age group)

•Husky Enrollment (total, by age, by band), for Husky A (Medicaid) and Husky B (CHIP)•Retention ratio


2008 Annually


Percent of enrollees in managed care Current as of Spring 2012 Current as of Spring 2012

Age, plan type 2007 Once every other year

•Number of enrollees•Percent of DC population enrolled in Medicaid•Eligibility standards relative to median state•Managed Care Enrollment•Spending (per beneficiary, percent of DC budget, by eligibility category, by provider category, for long-term care, by service type, to DC providers)•EPSDT rates (by age group)•Use of quality measures (MCO Plan accreditation, HEDIS Quality Measures, CAHPS, Pay for Performance, Public Reporting of Quality Measures)•Selected children and adult HEDIS measures of MCO plans (child: adolescent well-care visits, appropriate treatment for children with upper respiratory infection, adolescent immunization-Hep B, childhood immunization-MMR, primary care access age 12-24 mos, annual dental visit ages 21 & younger, appropriate asthma meds age 5-9; adult: cholesterol screening (cardiac patients), kidney disease monitored for diabetics, prenatal care, diabetes HbA1c testing, Chlamydia screening, cervical cancer screening, breast cancer screening)

Age, ward, plan, individuals with disabilities, eligibility category, provider category

•Patient satisfaction•Performance on national quality standards•Ease of accessing specialty care•Performance on national standards for care management•Patient perceptions of customer service•Performance on quality standards for specific health concerns (women screened for cervical cancer, women tested for Chlamydia, women who saw doctor in first three months of pregnancy, people with diabetes whose blood sugar is not well controlled, people with cough and given right treatment, people on same medication for long time and received blood tests, people with high blood pressure under control, people with dental check-up in past year, children with cold who received right medicine, children with sore throat and receive right treatment, children who received medicine and shots to prevent disease like measles, children 3-6 who went to doctor for check-up in past year, children 12-21 who went to doctor for check-up in past year, children testing for lead in their blood)

•Average monthly enrollment•Number/Percent enrollment in managed care/fee-for-service•Number of beneficiaries dually-eligible for Medicaid/Medicare•Spending (total, average per beneficiary/enrollee, by plan type, by service type (limited), by facility, for dually-eligible crossover claims, for DC vs. MD/VA/other state providers)•Amount of federal match (per dollar of DC spending)•Progress towards conversion to standard medical record forms for children


LTC facility type 2006 One time report

MSIS, other 2010 One time report

2008 Annually



•Number of licensed LTC facilities•Number of provider training sessions•Number of LTC facility inspections •Number of instances of incidents/complaints (investigated, substantiated, resulting in referral to adult abuse registry or Attorney General's office)•Sanctions to LTC facilities•Number of criminal background checks completed

•Medicaid spending (total, for long-term care, by long-term care delivery system , by 1915(c) waiver)•Number of beneficiaries (by delivery system, dual eligible for Medicaid/Medicare)

Population group (elderly/disabled, developmentally disabled), waiver type

Consumer experience with various aspects of care, including:•Ease of accessing care (various kinds)•Provider communications•Satisfaction with treatment

County, age, plan type, eligibility category Evaluating Medicaid Reform in Florida Project

•Race/ethnicity•Services received•Caregiver reports of overall childfunctioning•Caregiver reports of experience with care•Barriers to service (number, types)•Perceptions of important indicators of quality of care (by providers and caregivers)

Demonstration area (e.g., plan type: HMO vs. PMHP)

•Document reviews•Case record reviews•In-depth interviews•Administrative data

•Utilization of Medicaid-funded mental health treatment services•Cost of services (prior to admission, post discharge)•Number of admissions to State Inpatient Psychiatric Program (SIPP) (by gender, age, race/ethnicity, legal status DSM-IV Axis I diagnosis)•Number of involuntary commitments•Number of critical incidents•Cost of Baker Act exams•Average length of stay (by provider)•Number of discharges (by reasons, post-discharge placement, with prescription medications)•Number of days in the community at 60 days post-discharge•Readmission rate•Patient outcomes (Child Behavior Checklist scores, Children’s Global AssessmentScale scores)•Parent/caregiver satisfaction

Pre/post treatment in SIPP, specifically for individuals with developmental disabilities

•Administrative data 2000-2001 and 2003-2004•SIPP Provider Monthly Report Database (SPMRD) from CY2004•Qualitative interviews


2009 Annually

Racial/ethnic group 2005 One time report

SSI beneficiary status 2005 One time report


2009 Annually

•Expenditures for Low Income Program (LIP) and LIP-like programs (total, average per provider, average per individual served) •Individuals served in LIP and LIP-like programs•Services provided through LIP and LIP-like programs•Number of providers participating in LIP and LIP-like programs

Evaluating Medicaid Reform in Florida Project

•Beneficiaries•Eligibility loss rate and new enrollment rate (by TANF/SSI eligibility, age)•Eligibility for TANF, SSI•Mental and physical health services used (by TANF/SSI eligibility, age)•Self-reported physical and mental health status (by age, demonstration area/plan type)•Mental and physical unmet needs (by age, demonstration area/plan type)•Barriers to access (by age)•Satisfaction with care (by age, demonstration area/plan type)

•Enrollmentdata files from 1999-2004•Self reported data from mail survey of Medicaid enrolleesbetween 1998 and 2004

•Rate of death by suicide (age, race/ethnicity, sex, marital status, mental health diagnosis, substance abuse disorder, length of Medicaid eligibility)•Rate of Baker Act examinations•Medicaid expenditures (by type of service)

•Data from State of Florida on substance abuse, mental health (IDS/SAMH), fee-for-service medical, and pharmacy charges; Medicaid eligibility; and Baker Act (BA) activity for fiscal years 2001-2003•State Vital Statistics data on deaths during 2002

Patient/consumer perceptions about:•Process of plan and primary care selection•Health care access (particularly referral process, use of specialty services, prescription drug limits, and transportation barriers)•Enhanced Benefits Account program

Evaluating Medicaid Reform in Florida Project•Focus groups•In-depth interviews

•Application information (applications submitted, number of children referred to/approved for coverage, processing time) •Number of children enrolled (total, new, by age, race/ethnicity, parental education, household characteristics)•Length of enrollment•Expenditures (total, family contributions, state funding, federal funding, administration costs)•Average monthly caseload•Premium rates (total collected)•Satisfaction (application, program, premiums, access, quality of care)•Number of children with special health care needs•Number of children with a usual source of care•Use of services (self-reported)•Mean and Median BMI and number of children by BMI category (by age)•Access to employer-provided insurance coverage (measure of crowd-out)

Program [MediKids, Healthy Kids, Children’s Medical Services Network (CMSN, Title V of SSA), Medicaid, full-pay coverage options]

Administrative data, surveys of patients/families, CAHPS


Type of service, reform county 2009 Annually


2012 Quarterly

•Enrollment County, program Current as of Spring 2012 Current as of Spring 2012


Demonstration area (plan type) 2005


•Number of enrollees (by reform county)•Number of counseling sessions and vendor mailings (by type of activity/mailing)•Enhanced benefits rewards program enrollees who received credit, amount of credits earned, total amount of credits used•Call center utilization and performance•Enrollment in Opt-Out program


•Percent of enrollment by plan type (HMO, PSN, and MediPass)•Average per member per month expenditure by plan type

Medicaid eligibility group, demonstration vs. control counties, pre-reform vs. during reform

Evaluating Medicaid Reform in Florida Project•Claims and HMO payment capitation payment amounts

•Number of Enhanced Benefits Rewards Program beneficiaries•Credits earned•Purchases made (number, cost, and most frequent products)•Eligible services (recipient count, code count, and credits earned)•Enhanced Benefits call center performance (calls received, calls answered, average talk time, welcome letters, statements, etc.)

•Number of Family Planning Waiver participants and births•Baseline fertility•Averted births•Average expenditures (prenatal care/delivery, infants)•Cost savings

•Florida birth vital statisticsrecords•Medicaid eligibility and claims files

•Monthly enrollment (age, gender, SSI status, Serious MH Diagnoses)•Provider ratings of access, consumer choice, quality, outcomes, provider satisfaction, flexibility in providing services, continuity of services (input to output and across agencies), access to grievance procedures at the provider level•Penetration, use, and cost of services (general, carve-out, mental health)•Patient/caregiver reported unmet needs•Patient/caregiver experience•Children at risk for serious emotional disorder (SED)•Health outcomes (by age)

Multi-component evaluation (quantitative and qualitative data collection)

•Enrollment•Enrollee satisfaction•Enrollee-reported usual source of care and ease of obtaining usual source of care•Enrollee-reported physician communication•Enrollee-reported ease of access to care and services•Awareness of and participation in Enhanced Benefits program•Expenditures (total, change per enrollee per month, low-income pool (LIP)/LIP-related, special Medicaid payments (SMP))•Services provided (in LIP, LIP-related, and SMP)•Mental health examination rate

Plan type, demonstration vs. control group, age, race, ethnicity



2009 Annually

Enrollment Program Current as of Spring 2012 Monthly




•Number of women eligible for wavier (by age, income level)•Number of women enrolled (by age, race, eligibility category)•Number of women you receive at least one family planning service•Average inter birth interval•Number of repeat pregnancies

•U.S. Census Bureau Current Population Survey (CPS) Annual Social and Economic Supplement and adjustments provided by the Alan Guttmacher Institute•2007 Medicaid eligibility claims files

Performance on 26 indicators of maternal and child health care among Medicaid and non-Medicaid beneficiaries:•Number of deliveries (total, pre-term, to women who reported smoking during pregnancy, by pre-pregnancy BMI, to adolescents, vaginal deliveries with/without physical complications, by Cesarean)•Prenatal care (first trimester entry, inadequate)•Healthy Start prenatal risk screen (women offered, pregnant women screened, pregnant women screened at "high risk")•Women, Infants, and Children (WIC) nutrition program participation•Inter-pregnancy intervals (IPIs)•Number of births•Birth weight (low, very low, term low, and pre-term low)•Mother plans to breastfeed•Screening for health and developmental risk (infants screened, infants screened "at risk" for health and developmental problems)•Mortality (infant, neonatal post-neonatal)

Medicaid classification, race/ethnicity, type of provider

•Medicaid eligibility, HMO enrollment, and MediPass files•Birth and death files •Healthy Start prenatal risk and postnatal risk screens•Women, Infant, and Children (WIC) Supplemental Nutrition Programcertification files•Children’s Medical Services (CMS) High Risk Obstetrical Program files

•Enrollment•Health status (self-reported)•Patient experiences and satisfaction with: primary care, specialty care, other types of care, communicating with providers, and plan administration

Plan type, eligibility category, demographic characteristics (gender, age, education level, race/ethnicity)

•Medicaid Administrative Data•HMO Report Card project surveys•AHCA-administered surveys (CAHPS Health Plan, SF-12)

Patient/consumer perceptions about:•Definitions of health•Strategies to remain healthy or regain health•Ability of self and others to control health•Impact of money/resources and god/prayer on controlling health•Getting information about health/health care•Health care, Medicaid, and Medicaid reform•Provider relationships•Barriers to care•Treatment of Medicaid beneficiaries

Evaluating Medicaid Reform in Florida Project•Focus groups•In-depth interviews


2010 Quarterly

County, plan 2009 Annually

2009 Annually


Target population (TANF, SSI, Other) 2006 One time report

Care management organization Varies

•Pharmacy spending•Number/percent of beneficiaries enrolled in fee-for-service program•Average prescription services costs per fee-for-service user•Average retail price per prescription for fee-for-service users•Number of pharmacy claims per fee-for-service recipient•Percent of Retail Drug Expenditures Recouped through Manufacturer Rebates; Paid with Federal Funding; and Paid with State General Revenue•Medications for Aged and Disabled (MEDS-AD) Waiver Enrollment and Expenditures

•Number of reform plans•Market share and total enrollment, by plan•Enrollment activities•Reasons for voluntary disenrollment•Number of individuals eligible for Medicaid•Organizational representative perceptions of: Organizational landscape, organizational performance, reform elements (Enhanced Benefits program, consumer plan selection and transition counseling, Opt Out Program, and modified plan benefits), and operational successes and challenges

Evaluating Medicaid Reform in Florida Project, informant interviews

•Enrollment (new, active, by Partners in Care: Transitions for Kids (PIC:TFK) site)•Disenrollment (number, reason)•Active caseload (by PIC:TFK site)•Time to receipt of PIC:TFK service after being invited to participate•Satisfaction with benefits, quality of care•Service use (self-reported, by type of service)•Unmet demand (by service type)•Administrator ranking of usefulness of PIC:TFK protocols•Nursing care coordinators (number, change in time spent coordinating care after PIC:TFK referral, familiarity with eligibility criteria, attitudes towards hospice care)•Costs (by service type)

•Enrollment data for each PIC:TFK site•Parent satisfaction survey•Surveys of CMSN and hospice staff•Pediatric palliative care survey with CMSNNursing Care Coordinators from PIC:TFK and non PIC:TFK sites•Claims and encounter data

Enrollee experiences in•Quality of care•Patient involvement•Access to care•Coverage•Costs


•Number of health plans (HMO, PSNs, MPNs))•Medicaid and total state enrollment (number and percent) by state, two counties, and plan type


•Paid and denied claims by CMO, triage level of paid claims, hospital provider retention•Total dental claim payments, total incorrect payments, issues affecting claims payment accuracy.•Summary statistics on claim mis-payments

Encounter data from Myers and Stauffer, and supplemental data from CMOs


Care management organization 2009-2010 One time report

Number of enrolled Medicaid members not eligible (based on file audit) Yearly, but not all years posted 2011 Annually

Care management organization 2008 One time report

Care management organization 2011 Monthly

Analysis of CMO payments to providers One time report


Encounter data accuracy Managed care plan 2010 One time report

Managed care plan Claims 2011 Annually


Care management organization timeliness in releasing statistical reports to hospitals Care management organization 2009 Quarterly for 2009 and 2010

Care management organization One time report

Random sample survey 2010 One time report

•Hours per week dentist is available, status of if dentist is accepting new patients for payer, estimated percentage of business by payer, reason dentist is not treating or accepting patients, etc. •Geographic distribution of participating dentists, analysis of CMOs policies and procedures for determining dental network adequacy, comparison of dental participation levels between FFS and managed care.•Analysis of CMO acceptance or rejection of applications from dental providers to participate in their networks.

•Survey of dental providers

•Care management organization provider directories, MMIS data, Licensed dental provider list, dental association provider survey

Well child visits, childhood immunizations, lead screening, adult access to preventative services, members with diabetes who had HbgA1c test, use of appropriate medication for people with asthma

•Enrollment by region•Premium capitation payments made to CMO's, CMO payments to providers

Department of Community Health Cash Disbursements and Capitation Claims Records

•Snapshot of membership by CMO, CMO abandonment rates by month and plan, CMO blocked call rates by month and plan, CMO health benefit ratio (expense/revenue) by plan•Number of providers in rural and urban areas by plan

Access to care measures, quality of care measures, validation of methodology used by plans in reporting

Of connected calls number of times appointment was and was not scheduled, average appointment wait time, reasons for non-scheduling of appointments

Hospital Statistical and Reimbursement Reports

•Newborn Analysis- number of newborns where mother could not be identified, number of newborns with no claims, number of claims paid and denied, denial reasons •Encounter Claim Sample Validation- encounter confirmed as correct and incorrect, encounter claim error rate,

Eligibility files, CMO paid and denied claims, Georgia Families Capitation Payments, Traditional Medicaid and PeachCare for Kids UB04 Claims

Number of visits to the dentist, level of satisfaction with dental benefits covered, quality of dental care, wait time for appointment, number of dentists available, office hours of dentists available, and distance to dentists, use of ER for dental treatment

•Demographic characteristics such as age, rage and gender•Care management organization


Encounter data 2005

2006

Average monthly SCHIP enrollment Age, FPL (<=250%, >250% but <=300%) 2008

Insurance providers 2011 Annually

Plan HEDIS and CAHPS 2011



Program, plan Survey of providers 2011

2011

•Number of individuals enrolled•Costs of pharmaceuticals (rebates, realized savings)

•Direct payment amounts from QUEST Adult Health Expansion (ACE) program, by receiving hospital•Number of people enrolled•Federal benchmarks

Department of Human Services/Med-QUEST Division-Finance Office

•Number of claims•Drug Costs•Count of Unique Utilizers

Plan (AlohaCare QUEST, HMSA QUEST, Kaiser Permanente QUEST), reason for need (HIV/AIDS, Hepatitis C, organ transplant)

•Satisfaction (health plan, doctors’ communication and service, getting care)•Quality measures (asthma/COPD care, diabetes care, heart conditions care, cancer screening, emergency room use, behavioral health care)

•Satisfaction (health plan, doctors’ communication and service, getting care)•Quality measures (asthma care, diabetes care, heart conditions care, vaccinations for children, women’s preventive health, emergency room use)

•Standards and compliance scores•Performance on quality measures (compared to state and national averages and percentiles, where appropriate)

Provider satisfaction with:•Compensation•Timeliness of claims payments•Knowledge and expertise of health plan staff•How well health plan kept providers informed about utilization patterns and financial performance•Access to formulary and non-formulary drugs•Adequacy of specialists (overall and for behavioral health)•Range of specialists•Referral policy•Prior authorization process•Referral process•Formulary•Concurrent review•Discharge planning•Network of hospitals

Number of recipients receiving benefits under both QUEST and a private health care plan

Information reported to the Department by recipients


Plan 2011

2011 Annually

Enrollment (by month) Program, plan, island 2012

2004

2004

HEDIS and CAHPS 2009 One time report

Medicaid program type

•Expenditures (total, gain/loss, contracted expenses, percent spent by medical services and administrative costs, insurance premium tax, held in reserve, paid to shareholder, losses to capitation payments)•Medical loss ratio•Employment information (number of full time employees hired for contracted services, number of employees located in state by category of work performed, compensation to five highest-paid employees in Hawaii and nationwide)•State or Federal sanctions•Contributions to the community (overall and as percent of revenue)•Management and administrative contracts (amount and purposes)

Information submitted by the contracted health plans

•Total number of claims•Total costs •Total number of unique utilizers

Plan, medication type (brand vs. generic), medication class (anti-psychotic, anti-depressant, anti-anxiety)

•Expenditures on prescription drugs (total, by drug, for drugs granted prior authorization)•Total number of claims paid (by drug, by plan, for drugs granted prior authorization)•Average prescription costs•Number of recipients (unduplicated, by plan)•Average number of prescriptions per month•Cost per utilizer per month (PUPM), before and after implementation of preferred drug list (2003)

•Payments made to certified provider agencies for community mental health program services (paid amount, federal reimbursement)•FMAP percentage

Hawaii Prepaid Medical Management InformationSystem (HPMMIS)

•Satisfaction (health plan, doctors’ communication and service, getting care)•Quality measures (asthma care, diabetes care, heart conditions care, vaccinations for children, women’s preventive health, emergency room use)

Plan (AlohaCare QUEST, HMSA QUEST, Kaiser Permanente QUEST)

•Spending in Med-QUEST Division (overall and from federal funds)•Number of applications processed (overall, from FQHC by island)•Number of residents receiving care/medical assistance through or enrolled in Medicaid programs•EPSDT (eligible individuals, total screens performed)•Amount (in dollars) of cases of potential fraud referred to Attorney General, indicted, and convicted (by island)


Audit 2011 Annually

2012

2004

•Expenses (total health care programs, governmental activities)•Program revenues (operating grants and contributions)•Med-QUEST Special Revenue Fund (assets, liabilities, balances, expenditures)•Receivables (Medicaid providers, allowance for doubtful accounts)•Federal expenditures (by grantor/pass-through grantor)•Compliance and internal control findings for Medical Assistance Program (number of applications outstanding longer than 45 days, number of overdue annual re-verifications, PERM audit cases with eligibility error or undetermined cases due to insufficient documentation)•Details about instances of errors and subsequent overpayments

•Enrollment (by program, health plan, and island)•HEDIS scores (child immunization status, Chlamydia screening, comprehensive diabetes care, breast cancer screening, cholesterol management for patients with cardiovascular conditions, ambulatory care)•CAHPS (customer services, getting care quickly, getting needed care, how well doctors communicate, rating of personal doctor, rating of specialist seen most often, rating of all health care, rating of health plan)•Spending (by "without waiver" eligibility group and quarter)•Number of member and provider telephone calls and e-mails received for customer service assistance•Number of member calls received (by plan provider)•Number of network providers (for QExA only, by plan and island)•Number of medical claims submitted, received, paid, in process, denied (for QExA only, by plan and island)•Average time for processing claims (for QExA only, by plan and island)•Number of non-emergency ground transports (for QExA only)•Number of member and provider complaints and appeals (for QExA only)•Service utilization (admissions, readmissions, ER visits, number of prescriptions, etc.) (for QExA only)

•Outstanding claims payments (amount and as percent of total provider payments, amount denied, amount overestimated by providers)•Percent of claims submitted through Hawaii Prepaid Medical Management Information System (HPMMIS) claims processing system•Percent of payment delays caused by provider billing errors•Approximate percentage of providers who do not perform payment reconciliation from Remittance Advice•Percent of claims paid within 30 days


2011 Annually

2011 Monthly until April 2011

2011 Annually

One time report

2011 Annually

2007

2008 Quarterly

2012

2012

•Enrollment (total, growth from last year) by program•Unduplicated count of children ever enrolled, by Federal Poverty Level (FPL)•Number of applications (total received, number of renewal applications, number referred to Medicaid, number referred from Medicaid)•Number of applicants by how they heard of Hawk-I•Number disenrolled (total and by reason)•Expenditures (state, federal)•Number and cost of orthodontia cases through Delta Dental (total, approved, denied)

Summaries of Medicaid eligibles, recipients served, and total payments by county, category of service, and aid category

County, category of service, and aid category

•Hawk-I enrollment numbers and growth•Number of applications received•Number of children disenrolled by reason

30-day readmission rate (overall, by population, and by health plan): Comparison of Iowa to average of 16 States and benchmark (physical health only); payments for hospital readmissions within 30 days; top five major diagnostic categories

•Estimated cost savings (total, per state dollar spent, per federal dollar spent, per patient evaluated, on medication, on patient reviews)•Number of suggestions made, therapies changed, and impact rate (for patient-focused profile reviews, problem-focused profile reviews)

Iowa Medicaid Drug Utilization Review Commission

This report has a large number of measures and the following are examples:•Number of member calls received, answered; average queue time for members•Number of claims paid, number of claims denied, average days from recipient to payment; number of provider applications approved•State savings through collection of overpayments or avoidance of overpayments; overpayments recovered: number of cases and amount.

This report has a large number of measures and the following are examples:•Provider enrollment, applications received and pending, application approved and denied, average days from receipt to payment of claims•Claims prepay review (number of claims in suspense at beginning of quarter, at end of quarter, total processed); reviews and denials for various services

•Monthly enrollment (total and by age/eligibility category: children, adults, disabled, aged)•Expenditures (by type, age/eligibility category, long term care, acute)•Waiver waiting list status

•Enrollment (age/eligibility category: children, adults, elderly, disabled)•Expenditures (total, federal funds, state funds, county funds, expenditure category: hospitals, nursing facilities, physicians, mental health, HCBS waivers)


2012 Monthly

Waiver type 2008


2012

Total enrollment in Medicaid; percent of Medicaid eligibles of county population 2012

2006

2010

Service type Current as of Spring 2012

Managed care plan 2009-2010 Annually

Enrollment in managed care plans Plan Current as of Spring 2012 Current as of Spring 2012

Managed care plan 2010 Annually

•Enrollment growth (total and age/eligibility category: children, adults, aged, disabled)•Program funding (final for previous fiscal year, estimated for next two fiscal years)

•Number of individuals approved, in process, on wait list•Waiver spending (total, by source, and per person)

•Number of claims (paid by week, that required adjustments, pending, denied)•Number of system defects (by level of severity and priority level)•Number of escalated issues•Number of calls to call center (taken, abandoned)•Call center wait and talk times•Cost of interim payments (issued, provider payments recouped, returned/cancelled checks)

Evaluation requested by Joint Legislative Oversight Committee

•Provider reported status of contractor improvements in claims process•Pending claims

Provider survey and administrative records

•Number of eligibles•Costs (total, by type of service, for federally required vs. optional services)

•Acceptance rate for claims submitted, weekly average by month; weekly dollars and claims paid•Average number of weekly total calls, abandoned calls, wait times, talk times, by month

A&D, DD, A&D + DD statistics (number of participants, percent of participants, costs, percent of costs, cost per person on waiver, cost per user of service) by service type

•Health plan compliance with administrative requirements, validation of how plans calculate their HEDIS scores, etc.•Analysis of HEDIS Measures, and if plans are improving their performance

Typical HEDIS rates including lead screening in children, adolescent well-care visits, access to PCP's, etc



2011 Annually

2012 Annually

Plan type CAHPS 2011 Annually

•Spending by eligibility category•Number of Medicaid service providers•Percent of Medicaid spending on drugs•Managed care enrollment

Number of children enrolled, total claims paid, number of enrollees eligible for passive redetermination, number of enrollees with unpaid premiums.

This report has a large number of measures and the following are examples:•Enrollment (by age, race/ethnicity) and disenrollment trends; retention rate in CHIP•Access to primary medical providers and dentists•Summary of scores from CAHPS by health plan for ratings of health care, personal doctor, specialist, and health plan; getting needed care, getting care quickly, how well doctors communicate, and customer service. •Summary results for HEDIS access to primary care measures, well care measures, respiratory care measures by health plan. •Primary care visits, emergency room visits, preventive dental visits by age group and race/ethnicity; trends in medical per member per month for premium portion of CHIP•Average CHIP enrollment by MCO

Range of CAHPS measures relating to access, quality, and timeliness. Examples of questions asked include: •In the last 6 months, how often was it easy to get appointments with specialists?•In the last 6 months, not counting times you needed care right away, how often did your child get an appointment for health care as soon as you wanted? •In the last 6 months, how often did your child’s doctors or other health providers listen carefully to you?

This report has a large number of measures and the following are examples:•2009 Medicaid-SEHP provider and hospital payments•Durable Medical Equipment Cost Comparisons; Pharmacy Cost and Utilization; Utilization and Payment Statistics by Diagnostic Group; Paid Claims Volume


Webpage with list of audit reports conducted on Medicaid. 2011



2010 Annually

This report has a large number of measures and the following are examples:•Medicaid population distribution for health care program from 2005-2007•CAHPS measure for getting needed care and getting care quickly, comparison among HCK, national, Midwest. •CAHPS measure for high rating of personal doctor/provider, how well doctors communicate•Number of providers and caseload by focus area; Provider survey that asked questions such as "I am satisfied with being a PCP/PCCM in the (HCK/CMFHP/UniCare) program" and "In comparison to your patients in other health plans, (HCK/CMFHP/UniCare) patients have as much access to the prescription drugs they need."•Total and average HCK expenditures by population; top HCK expenditures by procedure•HCK population distribution; percent of eligibles who opt-in from 2005-2007; HCK age, gender, and race distribution

This report has a large number of measures and the following are examples:•Provider survey that asked questions such as "I am satisfied with being a PCP/PCCM in the (HCK/CMFHP/UniCare) program" and "In comparison to your patients in other health plans, (HCK/CMFHP/UniCare) patients have as much access to the prescription drugs they need."•Capitation expenditures by FY; consumers and average yearly expenditures on HealthWave XIX and XXI by category of service; HealthWave XIX and XXI gender distribution, ethnicity/race by year end 2007•Number of consumers in HealthWave XIX and XXI

This is a long report; below are just some examples:•Percent of providers indicating satisfaction with health plan•Percent of providers indicating access difficulties by health plan•Total and average HCK expenditures by eligibility category•Volume of enrollees by program, eligibility category, age (June 2005 – June 2008)


2010 Annually

2010

Plan type CAHPS 2011 Annually

All Kansas medical programs population counts by county County 2011 Annually

HEDIS 2010 Annually

2010

Population group and category of service Current as of Spring 2012 Monthly

Plan type 2008

This report has a large number of measures and the following are examples:•Medicaid annual enrollment by program•Child and adult CAHPS measures for getting needed care and getting care quickly; HEDIS comparison (in percentages) for access to primary care practitioners and preventive/ambulatory health services•Provider satisfaction with plan; satisfaction with claims system•Child and adult CAHPS measures for how well doctors communicate, customer service, shared decision making•HEDIS comparison (in percentages) for well infant visits, well child visits, prenatal care, postpartum care, diabetes care•HW 19 and 21 total and monthly expenditures FY 2004-2008 by category of service; Inpatient avg. length stay/days for mental health diagnoses; inpatient 30-day readmission rate for mental health diagnoses•Percent of HW population receiving care management by quarter

Number of claims reviewed, money identified for recoupment and amount recouped, cost to state, hospital recoupments following reviews

Range of CAHPS measures relating to access, quality, and timeliness. Examples of questions asked include: •In the last 6 months, how often was it easy to get appointments with specialists?•In the last 6 months, not counting times you needed care right away, how often did you get an appointment for health care as soon as you wanted?•In the last 6 months, how often did your doctors or other health providers listen carefully to you?

•HEDIS comparison (in percentages) for access to primary care practitioners and preventive/ambulatory health services•HEDIS comparison (in percentages) for well infant visits, well child visits, prenatal care, postpartum care, diabetes care

This report has a large number of measures and the following are examples:•Eligible children enrolled in Medicaid (percentage)•Hospitalizations for ambulatory-care-sensitive conditions; patients seeking inpatient care within their county (percentage)•Physician, dental and nurse to population ratio (per 100,000)•Quality measures for adult immunization, respiratory health, heart disease and stroke, diabetes, injury and violence, cancer, tobacco•State health expenditures, public and private spending, consumer spending

•Kansas Medical Assistance Program number of beneficiaries and consumers by population group and category of service•Average cost per beneficiary and consumer and total expenditures for Medical Assistance Program by population group and category of service

Provider survey that asks questions relating to satisfaction, patient access to services/treatments, customer service, non-pharmacy prior authorizations, finance issues, pharmacy and drug benefits, and other resources


2011 Annually

2011 Annually

Grand total eligible recipients, by age, race, sex and other social characteristics County 2012 Twice a Year

Grand total eligible recipients, by eligibility factor County 2011 Annually

2006

County 2012 Monthly

2011 Monthly until Nov 2011

Parish Current as of Spring 2012 Monthly

2011 Annually

2011 Annually

This report has a large number of measures and the following are examples:•Chronic conditions vs. national benchmark for measures such as patients per 1000 anxiety disorder, patients per 1000 asthma for Medicaid FFS and State Employee Health Benefits; Chlamydia screening percentages reported by commercial and Medicaid plans by state and year; adults, 50 years and older, who reported having a colonoscopy•Admits per 1000 acute by clinical conditions for Medicaid FFS and State Employee Health Benefits; hospitalizations for ambulatory-care-sensitive conditions: pediatric asthma

This webpage contains a list of utilization and claims data reports (all medical programs)

Recovery by federal, recovery by staff by the Medicaid Fraud and Abuse Control Division; number of MFCU convictions from 1999-2006

Number of Children Covered by Medicaid including KCHIP (KCHIP statewide total at bottom)

Number of Children Covered by Medicaid including KCHIP (KCHIP statewide total at bottom) by county; total newly enrolled children by category; eligibles change by category

•Children' enrollment by parish•LaCHIP enrollment by parish•Title XIX and XXI Enrollment Children Under Age 19

•Number of children enrolled in LaCHIP•Total expenditures and per member per month expenditures

This report has a large number of measures and the following are examples:Percent of uninsured Medicaid eligibles; percent coverage through Medicaid/LaCHIP; various uninsured rates for adults and children


Current as of Spring 2012 Monthly

2009-2010 Annually

Medicaid enrollment by parish and population group Parish and population group Current as of Spring 2012 Monthly


2011 Annually

Plan 2011 Annually


2009 2006, 2007, 2008, 2009

Most measures by year and region 2009 2002, 2004, 2005, 2006, 2009

Health plan 2011 Annually


•Annual enrollment numbers by children, parents, blind, disabled•Annual enrollment numbers by long term care/home and community based services

This report has a large number of measures and the following are examples:•Louisiana Medicaid enrollees and recipients by age, gender, basis of eligibility, and aid categories; Regular Medicaid children and LaCHIP enrollees, recipients and payments by age group and parish•Provider participation ratio•Louisiana Medicaid average annual cost per recipient; expenditures by budget category of service•Home and Community-Based Service Waivers eligible populations and income limits; Home and Community-Based Service Waiver slots and payments by state fiscal year

Number of audits conducted on acute hospitals, intermediate care facilities for the mentally retarded, community health clinics, temporary nursing service providers, ambulance providers, home health aides, adult day health, private duty nursing.

Spending for inpatient hospital care, professional services, prescription drugs, and diagnostic imaging services.

Breast cancer screening rate, cervical cancer screening rate, frequency of ongoing prenatal care, follow-up care for children taking ADHD medication, initiation and engagement of alcohol and other drug dependency treatment.

Variation in reimbursement levels by hospital type, use of institutional fees, variation in reimbursement levels.

•Number of people enrolled in HCBS waiver services•Number of people transitioned to the community

These are examples as there are many measures in this report.•Enrollment by: coverage group and year, race and ethnicity, age, and region.•Percent with an ambulatory care visit by: age group, region, and coverage group.•Percent with a well-child visit by: age, region, race and ethnicity.•Emergency department use by coverage group and age group, classification of ED visits by type.•Rate of avoidable hospitalizations for diabetes and asthma.

Claims, HEDIS, enrollment data

Satisfaction ratings for health plans in: access to care, doctor communication, care for kids with chronic illnesses, diabetes care, taking care of women.

Average number of ER visits by age group, percent of Medicaid recipients with no, one, and more than one visit, average number of ER visits by co morbidity level



2011 Monthly, quarterly, annually

2011

Number of CMS Performance Improvement Project Standards met. Plan and year 2011 One time report

Number of CMS Performance Improvement Project Standards met. Plan and performance improvement plan 2011 One time report





Month 2008 One time report

2010 Annually

•Number of newly eligible parents enrolled by county •Per member per month cost, estimate of averted uncompensated care.

•Dashboards on percent receiving services for: ADHD, asthma, COPD, congestive heart failure, dental visits, depression, diabetes, episodic mood disorder, flu shots, hypertension, pregnancy, substance abuse, and tobacco abuse.•Enrollment in MCOs by plan, month, and year. •Total capitation payments made to MCO's by county and plan.•Eligibility by year, delivery system, sex, race, and age.•Number of enrollees in nursing homes and receiving community based services by age, sex, race, and region.•Top five diagnostic groups by year, inpatient/outpatient, and delivery system.•Number of enrollees using services by type, year, and delivery system

County, some data is available by managed care plan, year, and rate cell

•Monthly enrollment trend fiscal 2007-2011, average percentage change in Medicaid enrollment fiscal 2008-2011. Enrollment mix FFS and MCO.•Average 2011 enrollment by eligibility category•Provider reimbursement by services type

Number of applications and people approved for services. Number of denials overturned, upheld, and awaiting hearing.•Number of services provided, number of individuals receiving services, number of providers providing services •Medicaid fee as a percent of average Medicare fee

Average percent Medicaid utilization by type of facility, facility assessment per day.

Pay for performance rankings of all nursing homes. Rank, staff ratio, total score, total value of pay for performance payments.•Number of prescriptions filled•Number of recipients of prescriptions•Number of dentists listed in provider directories by region, number of community clinic providers, number of children and pregnant women receiving services•MCO expenditures for dental services


FFS vs. managed care 2006 One time report



Disability status 2010-2011 One time report

Plan 2010-2011 Annually

2011

Plan 2012 One time report


Plan 2010-2011 Annually

2006 One previous report in 2004

•Aggregate prices for top 50 NDCs for adults and children •Average number of scripts per member month, mix of drugs utilized.

•Spending on outpatient children's mental health services, percent of costs attributed to: administration, program management, and direct care, total cost by service type•Number of children using services by type, number of providers providing services by type.

Total amount of overpayments, amount of overpayments for multiple units billed together, and amount of overpayments for incontinence supplies

Using an interactive tool you can look up how much MaineCare paid for a particular procedure, in a particular location

Procedure, insurer (MaineCare is only one option)

•Number of enrollees in each pre-paid inpatient health plan (PIHP), percentage of PIHP consumers by PIHP, number of enrollees using various services•Top diagnoses for inpatient admission, ER visit, and preventive/ambulatory visits, number of frequent inpatient/ER users, comparisons of service utilization by frequent and infrequency inpatient/ER users. •Top chronic conditions, extent to which continuous mental health plan enrollment impacted utilization patterns.

•Compliance monitoring, validation of performance measures, and validation of performance improvement projects.•Performance measure results by plan including pre-admission screening rate, follow up psych care for children and adults, and 30 day readmission rates for children and adults.

•Race, age, and health status of members. •Health plan rating, health care rating, rating of personal doctor and specialist. •Ability to get needed care, how well doctors communicate, customer service rating, ability to get care quickly.

Ratings by health plan on doctors communication and service, getting care, keeping kids healthy, living with illness, and taking care of women

•Number of enrollees served and cost of providing services. •State and federal program requirements followed or not followed.

•Average overall state weighted averages for HEDIS performance measures.•Validation of PIP projects

•Number of enrollees served, number of days of provided services, total cost, average cost per beneficiary.•Contractor compliance measures- e.g., completion of assessment every 90 days, documentation of consumer approval prior to implementation of care plan, units of services billed with proper documentation.


County, delivery system, and health plan 2012 Monthly

Number of enrollees by county by plan 2012 Monthly

Year and health plan HEDIS 2011 Annually


Health plan and program CAHPS 2010 2008, 2009, 2010


Number of children tested for blood lead before 2nd and 3rd birthday, number with blood lead test who are 1 to 6.

•Childhood immunization rates, well child visits, weight assessment and counseling, appropriate treatment for children with upper respiratory infection, appropriate testing for children with pharyngitis.•Breast and cervical cancer screening, Chlamydia screening, timeliness of prenatal care, postpartum care, adult BMI assessment•HbA1c testing and control, eye exams for diabetics, LDL-C screening, medical attention for diabetic nephropathy, blood pressure control, use of appropriate medications for people with asthma, controlling high blood pressure, medical assistance with smoking and tobacco use cessation.•Children's and adolescents access to primary care practitioners, adults access to preventive services, ambulatory care

•Comparison of infant mortality between MHCP and non-MHCP births, leading causes of infant mortality, prenatal care adequacy, infant mortality by maternal race, ethnicity, age group, county, length of enrollment in MHCP.

•Number of Medicaid births, percentage of low-birth weight births, distribution of low-birth weight births by maternal age, race, ethnicity, prenatal care.

Matched data file linking Minnesota resident birth certificates, death certificates and MHCP enrollment and claims data.

•Number of average monthly enrollees in Medical Assistance and MinnesotaCare, expenditures for 2011, average MinnesotaCare medical payment per month.•Number of people enrolled in family planning in 2011, monthly average enrollment, total spending.

•Rating of all health care, rating of personal doctor, rating of specialist seen most often, rating of health plan, getting needed care, getting care quickly, how well doctors communicate, customer service.

•Percent of continuously enrolled patients served by all dental providers by year and delivery system, number of critical access providers, MHCP dental patients visiting one or more providers.•FFS payment to charge ratio by critical access and non-critical access providers, percent of patients by geographic area and calendar year seen at practices designated as critical access, percent of visits by geographic area and year at practices designated as critical access.•Rate of visits to dental providers per 1000 enrollee months by calendar year, ratio of patients served per 1000 enrollee months by calendar year, percent of visits for selected services.

MCHP provider enrollment data, FFS and managed care encounter claims


Survey 2008 One previous report in 2003


Average monthly eligibles and total annual payments for Minnesota Medical Care Year 2012


2010 Annually


Enrollment Plan, eligibility group, county 2012 Monthly

CAHPS 2005

Number of recipients, total expenditures, and average cost per recipient Waiver by year 2010 One time report

•Health status of MHCP enrolled, average number of days health not good in past month, mental health status, health status by cultural group.•Use of acute, preventive, dental, and mental health services during past year, unmet need for health care during past year, financial and coverage barriers, percent reporting access barriers to care, percent reporting provider related barriers, concerns about practice style or low confidence in usual provider.•Percent reporting discrimination, need for interpreter services, relationship between barriers, use of services, and access (many sub-measures presented).

Child and adult, and Cultural group (race/ethnicity)

Number of seniors by county, health plan, and site of care (community, nursing facility)

This report has a large number of measures and the following are examples:•Ratio of Medicare to Medicaid rate: all physician services, primary care, obstetric care. •Minnesota FFS rates by type of CPT/HCPS code compared to other states. •FFS members per active FFS primary care provider by county, number of active, limited, and inactive FFS providers by county. Primary care utilization by site of care (ER, office visit, other hospital)•Level of primary care provider and specialist availability by region

Physician survey, member survey, survey sent to comparison states

This report has a large number of measures and the following are examples:•Percent receiving optimal diabetes care, percent receiving optimal vascular care, percent with depression remission at six month, percent controlling high blood pressure, percent with use of appropriate medications for people with asthma. •Screening rates for breast cancer, cervical cancer, colorectal cancer screening, Chlamydia screening.

•Most measures presented at the medical group level•Includes comparisons to private, employer-based health care insurance and Medicare programs

HEDIS and state constructed performance measures endorsed by NQF

•Statewide total of MHCP applicants with head of household identified as Hispanic, and who identified Spanish as primary language. Number and percent change of MHCP Hispanic and primary speaking heads of household applicants requesting interpreter services by county.

Overall rating of doctor, nurse, specialist, health care, counseling, and health plan. How well doctors communicate, problems with getting needed care, problems with health plan customer service.

Plan and Minnesota Health Care Program, some metrics by age


County, eligibility group, and program 2010 Annually


Race, delivery system, and year 2010 One previous report in 2008

Age group, county, and year 2010 One time report

Telephone survey 2002

Number of persons ever eligible during year, number of SCHIP unborn eligible by county, monthly average eligibles, person months of eligibility during year.

•Costs•Eligibility

Costs by county, eligibility group, delivery system (FFS vs. Managed Care), and for both Medicaid and SCHIP

Eligibility for both Medicaid and SCHIP

Race/ethnicity enrollment snapshot by delivery system, well-child visit rates, adolescent well-child visit rates, adult primary care visit rates, Chlamydia screening rate, cervical cancer screening.

HEDIS like measures from FFS claims and managed care encounter data.

Number of recipients of nursing facility services, recipiency rates per 1,000 at risk in age group and county.

•Rates of behavioral disorders, rates of mental disorders, rates of substance use disorders, rates of individual disorders (depression, generalized anxiety, social phobia, agoraphobia, panic attack, PTSD, alcohol dependence, drug dependence.)

•Rates of co morbidity , combined mental and substance use disorder rates, rate of consultation with any professional for disorder detected in the survey, rate of people consulting mental health specialists, doctor, and human services provider, use of human services, alternative care and self-help by those who did not consult a mental health specialist or doctor, rates of treatment offered by doctors, types of treatments offered (psychotherapy, medication, both), completion rate of treatment offered, reported barriers to completing treatment, ratings of treatment.

•Rates of behavioral, mental, and substance use disorders (MN Medicaid, US Medicaid, US Total), comparative rate of professional service utilization among those with disorder, reasons reported for not completing all offered psychotherapy or medication.

By prepaid medical assistance plan, in comparison to national Medicaid rate and US overall rates.



2005


Provider and Patient Survey

•Prevalence of at least one: mental disorder, substance use disorder, behavioral health disorder. Percent receiving treatment, percent offered treatment, satisfaction rate with treatment, number of barriers to psychotherapy, use of alternative treatments, satisfaction with alternative treatments.

•Prevalence of specific behavioral disorders (ex, depression), percent with more than one disorder, percent with an objective need for treatment (as defined by the study).

•Percent getting treatment from mental health specialist or doctor, percent getting medication offered, percent receiving medication offered, percent where psychotherapy was offered, percent receiving psychotherapy.

•Satisfaction with and level of functioning among those who reported receiving standard treatment, self reported results of treatment, barriers to psychotherapy for those who did not receive all of their therapy, barriers to treatment for those who did not receive all of their medication, contact with providers other than doctors or mental health specialists, percent using alternative care, satisfaction with alternative care.

By program: Prepaid medical assistance program, prepaid general assistance medical care, MinnesotaCare, Minnesota Senior Health Options, Medicaid FFS, Commercial insured, and uninsured.

Number of children tested for blood lead, percent of children tested for blood lead, percentage of tested children with EBLLs, percent of children with EBLLs with follow up tests within 3 months, percent tested by race/ethnicity, percent of children with well child visits tested by race/ethnicity, rate for all EBLLS by race/ethnicity, rate of 3 month follow-up test by race/ethnicity.

By status of enrollment in Medicaid, age, and year.

Medicaid enrollment data and data from the Environmental Health Division of the Minnesota Department of Health

Second report. This report is an update to a study from 1995-1998

Number of emergency room visits among children who had a medical crisis, number of office or clinic visits among all children, percent of children with a visit where the visit was a preventive visits, percent with a usual source of care, percent with personal doctor, ranking of relative importance of health care visits for preventive services, after an illness, and for shots.

•Percentages of dentists reporting that given portions of their patients and revenues come from MHCP, percentages of dentists reporting profit/break even/loss from involvement in MHCP, percentages reporting various criteria for accepting new MHCP patients (ex. family of current patients), ratings of significance of problems with MHCP (ex. MHCP patients make other patients uncomfortable), mean scores for items assessing importance of problems with MHCP (ex. broken or canceled appointments), ratings of plans in which provider participates, usual, acceptable, and DHS fees for various procedures, mean scores for proposed methods of improving access. •Percentage of those receiving care who had difficulty finding a convenient dentist, reasons for not getting care among those who needed but did not get care.

2002


2001

Survey of MHCP enrollees 2003

Focus Groups 2001


2002 2001 and 2002

This report includes a large number of measures and these are illustrative examples:•Percent of children seen at HealthPartners dental group clinics who required restorative or surgical care, percent of MHCP beneficiaires receiving one or more dental services•Number of dentists by county with availability for new MHCP patients•Retail value of restorative care for children at HealthPartners Dental Group Clinics

This report includes a large number of measures and these are illustrative examples:

•Health status of children and adults, how recently MHCP enrollees used services (ex. more than 5 years ago), use of services by race or ethnicity, percent reporting financial and coverage barriers to care, percent reporting problems accessing care, percent reporting problems trusting doctors, percent reporting discrimination, percent reporting unfair treatment based on MHCP status, experiences with interpreters.

Medical Assistance and MinnesotaCare enrollment by race, age, and child/adult. Activities that communities use to keep from getting sick, people and places communities visit to stay healthy, reasons individuals, families, and communities do not receive services.

•Total MCO MSHO plan membership by plan, number of MSHO enrollees in plans paid PPS vs. per-visit/blended•Average number of days to process home health agency claims for Medicaid managed care , MSHO, MNDHO, Medicaid FFS (and in comparison to Medicare)

Home health reimbursement methodologies work group, key informant interview, home care agency survey, data from the Minnesota Department of Health and Minnesota Department of Human Services

Percent in each setting of care, enrollment by age group and gender, enrolles by race and ethnicity,


2001

MSHO vs. PMAP Mail survey 2004

MSHO vs. PMAP 2004

This report has a large number of measures and what follows are illustrative examples:

•Self rating of general help, age, gender, race, marital status, education, overall rating of health plan, overall rating of health care, response to would you recommend health plan to others, response to would you recommend this nursing home to others.

•Response to: have you heard of or received information about MSHO or your health plan, how often are you involved as much as you want in decisions about your health care.

•(MSHO members only). Response to: now that you are in your current health plan do you notice anything different about the services you receive, how would you describe the transition to your current health plan, since joining your health plan do you feel you see your doctor more/less often.

•Response to: If you need services like occupational therapy, PT or speech therapy you receive them, your hearing and eyesight are checked regularly, your doctor or nurse responds quickly to you if you get sick, your doctor sees you often enough to treat your health problems.

MSHO vs. PMAP, beneficiaries vs. families

In person interviews and mail survey


•Responses to: when you call the health plan, how satisfied are you that you get the help you need, how often do you talk to the health plan, how satisfied are you with the respect the health plan shows you, how satisfied are you that the person who coordinated your family member's care provides assistance in getting the health care services your family member needs.

•How often do you talk with your family member's doctor about the care your family member receives, how satisfied are you with your family member's doctor.


•MSHO enrollment by plan and rate cell, percent of enrollees with 0-4 chronic conditions, enrollment by health plan by settings of care (community well, community frail/EW, nursing home,), ADL/IADL needs of MSHO and PMAP community frail/EW enrollees, total population of MSHO and PMAP enrollees by setting of care, age, and gender.


MSHO vs. PMAP Survey 2002


2010 Annually

2012 Monthly


Most measures by admission type

•Family member rating of health plan, percent who would recommend health plan, family member rating of doctor, percent who would recommend doctor, family rating of nursing home, percent who would recommend nursing home. Satisfaction with getting help needed when calling about family member, staff listening when talking with them, staff showing respect, staff person involving them when making decisions about family member's care, staff taking family member's special cultural needs into consideration, satisfaction with health plan staff resolving problems that arose, how much of a problem it was to get care for their family member, how much of a problem they had with medical bills for family member.

•Satisfaction with care coordination staff solving problems that arose regarding family member's health care and with providing assistance in getting the health care service their family member needed, satisfaction with doctor responding quickly if family member got sick, doctor seeing family member often enough, doctor explaining family member's health problem in a way they could understand, responded to their concerns when their family member was having serious health problems, hospitalized their family member when their health problems required it. Number of respondents making complaints about their nursing home, how satisfied with how complaint about nursing home was handled.

•HEDIS and HEDIS-like measures including well child visits, prenatal care, post-partum care, childhood immunizations, and cervical cancer screening.•Managed care provider to enrollee ratios, by plan and geographic region, for PCP's, dentists, and mental health providers.•Enrollment by eligibility group, region, and delivery system. •Consumer ratings of managed care plans.

Average monthly applications, closings, and caseload by eligibility group. Average monthly approvals and closing for eligibles.

•Number of applications received, approved, rejected, and pending. •Recipients and payments by type of service

Eligibility category, region, Medicare dual category

FFS benchmark costs, managed care costs, 2009 savings, benchmark PMPM, managed care PMPM, FFS benchmark expenditures by type of service and Medicaid vs. CHIP, managed care expenditures by type of cost of Medicaid/CHIP.

This report has a large number of measures and the following are examples:•Inpatient hospital- number of FFS admissions and FFS days, total paid, amount paid per admission and per day, average length of stay.•Statistics by individuals' number of admissions- number of persons, number of admits, medical costs, behavioral cost, probability persons reaching the level will have at least one more admit or three more admits.•Outpatient hospital amount paid per year, number of claims and amount paid by service type, number of claims and amount paid by revenue code.



Year 2009 One time report

Total expenditures, total trips, and per trip cost Year 2010 One time report

Total recovery and cost-avoidance. Year and provider type 2010 One time report

Number of eligibles, total dollars spent, dollars spent by service category. 2011 Current as of Spring 2012

County, judicial circuit, region, and MSA

Year 2009 One time presentation

Year 2008 Annually

Number of deliveries per calendar year and state fiscal year. 2009 One time report

2012


PMPM costs for primary care case management 2010 One time report

2011 Monthly

This report has a large number of measures and the following are examples:•Number of beneficiaries in each "cost cohort," their total percentage of program beneficiaries, their costs, and their percent of costs. •Number of beneficiaries with high pharmacy usage, total costs and average costs for these beneficiaries.•Number of inpatient admissions per individual, costs for medical and behavioral services by number of inpatient admissions. Number of ER visits by individual.

Gross and net pharmacy costs, PMPM pharmacy cost, generic drugs as a percentage of prescriptions and costs,

•Percent of children and adults participating in Medicaid•Per capita Medicaid spending, percent of births paid for by Medicaid, percent of inpatient hospitalization paid for by Medicaid, percent of ER visits paid by Medicaid.

•Number of Medicaid and CHIP beneficiaries•Total claims paid, total cost by type of serviceAverage cost of Medicaid and CHIP beneficiaries, total claims payments, major provider category payments, total payments by service type.

•Medicaid enrollment for most recent 24 quarters•HMK enrollment by month and eligibility category

Eligibility category, reports available by quarter or month

Average days of care for Medicaid nursing home recipient, annual average Medicaid reimbursement, nursing home and HCBS utilization, monthly enrollment, costs by eligibility category

•Medicaid eligibles by fiscal year, Medicaid eligibles by month•Medicaid fiscal year payments


2007

Enrollment by county and city/town 2011 One time report

Year CMS 64 2010

MMIS 2012 Annually

2011 Annually

2010 2009, 2010

Monthly authorized to receive services by county, program category code. 2012 Annually


•Average monthly cost by Medicaid eligibility group and age, Medicaid expenditures as a percent of total expenditures by eligibility group•Medicaid enrollment by eligibility group

Medicaid expenditures for long-term care services by type of service, expenditures as compared to other states.•Number of eligibles (total, averge per month, who received services) •Number of active Medicaid providers

Active Medicaid eligibility cases by county, aid program by county, aid program statewide.

Average time to resolve hearings, cost savings from reduction in appeal time by service type, cost per day per appeal, number of mediations resulting in dismissals, uphold of initial decision, modification of initial decision, referral to formal hearing, petitioner not participating, petitioner not being available.

Medicaid and North Carolina Health Choice for Children

•Total Medicaid expenditures, program expenditures by type, expenditures and recipients by type as a percent of total, annual cost per recipient by eligibility category, total costs by fifteen most expensive categories of service•History of annual eligibles, recipients by gender, age, and race•Third party recovery amount


2012 Annually, monthly

Medicaid vs. Health Choice 2010 One time report

2010 2009, 2010


2011 Annually

2010 2009, 2010

Number and percentage of dual eligibles enrolled in CCNC/CA by aid category, Medicaid enrollment by county, number, and percent of recipients eligible to be enrolled in Carolina ACCESS, number of recipients exempted by exemption code by county. Number of North Carolina Health Choice recipients enrolled in CCNC.

Demographic characteristics, insurance coverage consistency, usual source of care, personal doctor, preventive health care, health status, weight status.

Parental surveys through the North Carolina Child Health Assessment and Monitoring Program (NC CHAMP)

•Number of MDEZ forms prepared and distributed to networks by drug class, count of potential prescription problems per patient by event type (ex, absolute contraindication), number active new e-prescribers in July 2009, eRX facilitator interactions by months, eRX facilitator interactions by type, percent of patients meeting quality measures in diabetes management, asthma, hypertension, smoking status and cessation advice, IVD, heart failure by network.•By network: Preventable readmissions as a percent of total admissions for non-duals, inpatient admissions for non-dual ABD, ED rate for ADB, generic medications as a percent of all fills all non-duals, percent of providers actively e-prescribing. E-prescribing volume, average amount paid pre-rebate per prescription, number of unique visits, number of hits, average visits per day, and average duration of visit to e-prescribing system. Market share of selected preferred and non-preferred drugs before and after prior-authorization requirements.•Practice distribution by number of enrolled patients, patient distribution by practice size, % of ABD patients meeting criteria receiving health assessment or intervention, disease prevalence among elderly and disabled NC Medicaid recipients

•Number of private duty nursing recipients, hours of private duty nursing, number of home care agencies providing services, approved hours and medical condition of private duty nursing recipients•Cost of private duty nursing (by child vs. adult), average cost per recipient, skilled nursing costs for recipients, other costs for recipients, hourly cost of private duty nursing, daily cost of nursing facilities.

By county and statewide:•Medicaid births by mother's age, Medicaid eligibles by age or group, Medicaid eligibles by race and ethnicity, eligibles enrolled in CCNC•Average cost per recipient by type of service and adult or child, total average enrollee cost•Number of adult and child service users by type of service, mental health utilization by type of service, •Number of recipients, and cost, number of recipients and costs for emergency services for non-citizens, dental utilization, CAP program, prevention quality indicators rates.

Number of appeals, number pending, number closed and resolved. Number of program integrity provider appeals for medical review, home care, and pharmacy. Number of appeals of nursing home and adult care home transfer, discharge, and PASARR appeals.


Month 2012

Rate and ethnicity HEDIS 2010 Annually

2009 2008, 2009

Age and county 2010 Annually

Care network 2009

2008 Annually

2010

•Net paid for all services, PMPM for all services, recipients for all services, all eligibles. •Inpatient maternity, inpatient non-maternity, primary care physician, ICF/MR, ER, adult care home and personal care services, pharmacy brand, pharmacy generic•Average admissions per recipient, admissions per 1000 eligibles, average cost per admission. Net state paid by service type.

•Breast cancer screening, cervical cancer screening, colorectal cancer screening, comprehensive diabetes care, use of appropriate asthma medications, child immunization rates, adolescent immunization rates, follow up after hospitalization for mental illness.•Annual dental visit, prenatal care, adult access to preventive ambulatory services, childhood access to PCP. Well child visits, adolescent well care visit, ambulatory care, inpatient hospital utilization, selected procedures.

Total monthly enhanced services expenditures, individual community support expenditure s by month and all other enhanced services expenditures by month.

Number of Medicaid enrolled children eligible for EPSDT program, number receiving at least one or periodic screenings, participation ratio.

Preventable readmissions, inpatient admissions, and ED rate, generic medications as a percent of all fills, % of providers e-proscribing, diabetes A1C less than or equal to nine, diabetes LDL cholesterol control, diabetes foot exam, asthma continued care visit, cardiovascular BP, aspirin use, lipid testing, smoking status and cessation advice, heart failure beta blocker use.

This report has a large number of measures and the following are examples:•Medicaid eligibles by eligibility group, change in eligibles by eligibility group, recipients of Medicaid services by eligibility group, race, gender, and age•Service usage by category•Number of recipients of behavioral health services and cost•Medicaid services expenditures by category•Claims and expenditures for the elderly•Number of pharmacy authorization denials, number of referrals for nursing home care•Number of enrolled providers by provider type

•Average claim processing time•Actual PMPM, planned PMPM, cost per recipient, enrollment (by type of service)



2009

Co-pay status 2009 Annually

Waiver year 2011 Annually


•Medicaid recipients as a portion of state population•Medicaid caseload by aid type, for children and low-income parents•Medicaid caseload and expenditures for aged, disabled, and families and children•Average paid per recipient by type•Top 15 most expensive services and amount paid for each

Mental health drug quarterly PMPM, overall PMPM for adults and children, top mental health drug categories impacting PMPM for adults and children, PMPM by drug category and age range.

•Average monthly enrollment, annual enrollment by age group, gender, ethnicity. Inpatient admission rate, day rate, average length of stay, average charge per admission, average charge per day, admissions by diagnostic classification, admissions, length of stay, members, and average charge per admission by county. •Inpatient utilization statistics for mental disorders at acute care hospitals and psych hospitals: admissions, days, average length of stay, average allowed charge. •Hospital outpatient visit rate, emergency room visit rate, ambulatory survey visit rate. Total ER utilization and charge per visit by emergency, urgent, and non-urgent visit type.•Primary care physician visit rate, specialist visit rate, outpatient mental health utilization statistics for alcohol abuse and drug abuse.•NC Health Choice PMPM by place of service, diagnostic category, frequency and costs of selected office procedures, costly admissions to acute care hospitals.

This report has a large number of measures and the following are examples:Female and male enrollment rate by age, number of vasectomies, number of women with an initial or annual examination, contraceptive use by type, estimated annual births and averted births.

MMIS Claims and eligibility files, Health Services information System reports, Vital Statistics Data, Pregnancy Risk Assessment Monitoring System, American Community Survey, Participant survey, non-participant survey, baseline fertility rate calculations

Expected dollars from notices of overpayment sent, number of notices sent, number of opened and closed program integrity cases, number of providers referred or suspended per month, recipient fraud and abuse complaints, active and negative Medicaid case review activities, active and negative NC health choice review activates, number of opened and closed cases for third party liability, vendor recoupments, estate recovery, and casualty/tort liability, original notice of overpayment amount vs. final AR setup amount.





Claims data 2011 2009, 2011

Sample of claims data 2011 One time report

2004

2005

•Number of Medicaid patients with diabetes, CHF, and COPD, number of home health visits for these patients, home health, hospitalization, and ER visit costs for these patients. •Patient self-efficacy for managing chronic disease symptoms pre and post-telemonitoring, correlations of telemonitoring contact to post-monitoring patient self-efficacy, patient satisfaction score with telemonitoring•Caregiver report of strain, nurse reported telemonitoring equipment use of ease and usefulness•Hospital admissions and outpatient/ER visits in consecutive study periods, study participant average weekly Medicaid claims

•Percent of Medicaid population that are dual eligibles, proportion of Medicaid population making up nursing home and community alternatives for disabled adults population•Proportion of Medicaid budget spent on nursing home and community alternatives for disabled adults population.

•Call answer timeliness, call answer abandonment •Denied claims•Inpatient discharges, readmittance to inpatient MH facility within 30 days, readmittance to SA facility, follow up after hospitalization, MH utilization, identification of alcohol and other drug dependence, initiation and engagement of alcohol and other drug dependence treatment•Member months of enrollment, diversity of membership,

•Total expenditures by level of service•Number of children served by level of need, •Distribution of length of stay by time period, age distribution of children served by time period, proportion of total days by diagnosis type by time period.

Average annual Medicaid cost for all services for those with HIV and those with AIDS. Average annual Medicaid cost for prescribed medication for those with HIV and those with AIDS.

Number of children enrolled in Carolina ACCESS number with chronic asthma, and percentage of children with chronic asthma by year and study group. Percentage of children with chronic asthma: receiving appropriate control medications, having one or more ER visits per fiscal year, number of ER visits per 1,000 children ages 5-17 with chronic asthma per fiscal year, average amount paid per ER visit per child, having one or more inpatient stays per fiscal year, number of inpatient stays per 1,000 children ages 5 - 17, average amount paid for inpatient stays, having four or more outpatient visits per fiscal year, number of outpatient visits per 1,000 children ages 5-17, average amount paid per outpatient visit, having four or more asthma control medications, number of asthma control medications per 1,000 children ages 5-17, average amount paid for asthma control medications per child.

Medicaid claims data and HEDIS

Primary care provider outpatient visit rates for intervention and control practices, primary care provider outpatient visits per member per month costs for intervention and control practices, urgent care center visit rates for intervention practices and control practices, urgent care visit costs for itervention practices and control practices.


2002


2010

2007

2004

2011 Quarterly

2011 Annually


Average cost of nursing care 2010 One time report

Proportion of Medicaid children with special health care needs, immunizations/lab tests administered as required among children with special health care needs, immunizations/lab tests administered as required using an extended schedule, health check visit components documented in medical charts, medical record components documented in the children with special health care needs medical charts by gender, chart reviews by demographic characteristics, chart reviews by demographic characteristics by system of care, medical record components documented by system of care, immunizations/lab tests administered as required among children with special health care needs by system of care.

•Number of clients served in 2001, average number of clients served per month•Average cost per month to Medicaid, total expenditures from Medicaid program

Enrollment category (Medicaid waiver versus Nursing Facility)

Medicaid General Info and Medicaid Waiver: Current as of Spring 2012Fact Sheet: 2001

Medicaid General Info and Medicaid Waiver: Current as of Spring 2012Fact Sheet: One time report

•Number of recipients receiving services, percent of recipients by eligibility category•Expenditures by eligibility category, average price of prescriptions, amount paid by drug class.•Percent of eligibles served by managed care vs. FFS, MCO enrollment by fiscal year•Average number of prescriptions per person per month, number of recipients fillings prescriptions

Major Medicaid costs by year and category, average annual Medicaid eligibles and recipients, CHIP average annual recipients

Actual and project expenditures by type of service, actual and projected expenditures for long-term care services including waivers and nursing home care

North Dakota funds appropriated and federal expenditures on nursing home care by year, North Dakota funds appropriated and federal expenditures on HCBS by year

Examples of survey questions:Ease of applying for Medicaid, usefulness of help from county eligibility worker, feel you have a good understanding of program benefits and services, need for information on how recipient liability is determined, need for information when there are changes in services, frequency of hospital ER room visit, had trouble getting needed dental care

Medicaid eligibles for prior 12 months, recipients for all in past 12 months, number of eligibles under age 21, over age 65, disabled, and adultsCount of Medicaid cases and recipients, count of Medicaid recipients by race, count by age group, county by human service center region

Number of teens receiving prenatal services through CHIP, number of pregnant woman denied Medicaid coverage


Varies


Year 2011 Annually

Number of eligibles per year from 1987-2005 2005 One time report


2005

Age Varies: 2007-2009

•Aged and disabled expenditures by diagnosis, average monthly cost per eligible, expenditures by eligibility category, expenditures and eligibles by age group and urban/rural•Inpatient hospital average monthly recipients by group, long-term care expenditures FY 99-05, Medicaid expenditures by service, outpatient hospital spending by recipient group, outpatient hospital average monthly recipients group, physician, practitioner and EPSDT expenditures, prescription drug expenditures by number of prescriptions by client and by top 7 therapeutic classes, vendor expenditures by type of service

Number of callers to help line with Medicaid/Kids Connection, satisfaction with family navigator (in comparison to privately insurance clients)

•Medicaid and CHIP average monthly eligible persons by category •Vendor expenditures (by eligibility, service)•Medicaid expenditures for long-term care services, nursing facility, pharmacy, inpatient hospital, and home and community services

Average monthly eligibles by eligibility category, average vendor and general fund expenditures

•Total cost of Medicaid services, number of individuals covered, dollars spent, and per-person cost by eligibility category•Number of cases of suspected provider fraud investigated, number of cases with recouped payments, and total amount recouped•Amount collected through drug rebates and estate recovery.

•Primary care reports- Site of care for primary care services, prevalence and utilization for mental health disorders, well child visit rates•Depression reports- Depression diagnoses of Medicaid members, impact of depression, utilization and costs related to depression•ER Use Report- utilization and payments of frequent ED users•Preventative Services Report- access to preventative/ambulatory care, breast cancer screening, cervical cancer screening, colorectal cancer screening, etc

•Administrative claims data and NH APD

•HEDIS


2009 Annually

2008 2007, 2008

2010 Annually

2002

Error rate for sample of acuities, amount of voluntary reimbursements by providers 2009


2007



Enrollment by county for children and adults 2012

This report has a large number of measures and the following are examples:•Enrollment by month and age, as percent of total child population in health analysis areas, length of enrollment, disenrollment and reenrollment•Percent with access to primary care provider by age, Medicaid/SCHIP, average number of months from enrollment to first PCP visit•Percent with well child visits, by age, number of visits, effectiveness of care (example- prevalence of asthma)•Prevalence and utilization for mental health disorders•Utilization and payments

•Administrative claims data and NH APD

•HEDIS

This report has a large number of measures and the following are examples:Access to primary care practitioners, well child visits, childhood immunizations, appropriate testing and treatment for common acute illnesses

NH compared to Vermont and Maine and National averages

NH APD, using HEDIS measures

•Enrollment (by eligibility category, age, month, gender, as a trend, and by geographic region)•Payment by type of service (by eligibility category)•Percent of children receiving a primary care visit during the year, adults access to preventative services, percent with well child visits, etc.•Utilization and costs by eligibility group, HCBS or nursing facility status, dual eligible status, geographic area

Number of appeals on nursing facility rates, number of appeals on acuities, number of audits and amount of overpayments, number of unaudited nursing facilities, accounts receivable balance for sample of nursing facilities, amount recovered from overpayments to deceased beneficiaries

Amount improperly billed for DME, number of beneficiaries receiving more than one blood pressure monitor during audit period, estimated overpayment amount for DME recycling services

Number of sampled Medicaid recipients with income above limit for programs in which they were enrolled, number of sampled recipients not redetermined within 12 month period, number of sampled recipients missing documentation, amount of ineligible claims and recovered amount by county

•Number of enrollees by monthly income•Number of cases not receiving renewal application, total amount of self-employment income not reported by participants, total premiums owed for disenrolled cases

Number of errors in MCO reported number of dentists in MCO network, percent of selected specialists not at location listed by MCO's not seeing Medicaid patients, and not accepting new patients


HEDIS and CAHPS 2010 2009, 2010

Number enrolled by eligibility category and program, number enrolled by county 2012 Monthly


2004

2012 Annually


•Number enrolled, overall compliance score, childhood immunization status, well-child visits, adolescent well-care visits, lead screening in children, timeliness of prenatal care, postpartum care, breast cancer screening, cervical cancer screening, use of appropriate medications for people with asthma, HbA1c testing, HbA1c poor control, eye exams, LDL-C screening, medical attention for diabetic nephropathy.•Members' overall rating of their health plan, overall rating of child's health plan, rating of overall health care, getting needed care, ability to get needed care from specialist, rating of personal doctor, rating of specialist, rating of customer service responsiveness, number of dental visits, overall rating of dental care, how often personal doctor seems informed about care received from other providers, emergency room visits

Plan, some measures broken out for children and adults

Number of children and adults enrolled and disenrolled. Trends of likely future enrollment

•Number of participants in NJ Family Care by plan•Number of beneficiaries with invalid SSNs•Number of complaints on eligibility decisions per month•Number of applications processed within specified times•Number of renewal cases in missing information status•Overpayments for parents no longer eligible after children were not enrolled•Number of beneficiaries who did not pay required premium

Both reports assess health plan compliance with performance improvement plan standards including in the areas of study topic, study question, study indicator, identified study population, sampling method, data collection procedures, assessment improvement strategies, review plan for data analysis and interpretation of study results, assess whether improvement is real improvement and assess sustained improvement.

(Same measures presented in both reports) Case review scoring by type of denial, overall score for case review and agreement rate, percent of actions deemed correct by type of case




2011 Annually

•Number enrolled in CoLTS by category, and dual status, number enrolled in Non-CoLTS HCBS waivers, number in PACE, number of ICF/MR residents •Enrollment in CoLTS by Medicaid Eligibility Group, estimated average PMPM cost for CoLTS population by Medicaid Eligibility Group, LTC service distribution under CoLTS and FFS•Percent of expenditures on LTSS spent on HCBS, number of people enrolled in CoLTS, total costs by year

•Percent of encounters matched to consumer files, total encounters validated by data element, exact match of primary care encounter data with medical record data, total MCO no match categories, dental encounters with total match by data element, total MCO dental data elements with no match categories, inpatient encounters and outpatient encounters by data element validation. Overall diagnosis agreement, procedure code overall agreement.

•Outpatient data elements by validation results and no match categories, PSR data elements by validation results and no match categories, inpatient admission data elements by validation results and no match categories, RTCS data elements by validation results and no match categories, BH pharmacy data elements by validation results and no match categories, percent of encounters with total match by category.

Physical Health: 2010Behavioral Health: 2007

Physical Health: One previous report in 2007Behavioral Health: One time report

•Percent of enrolled members with asthma appropriately prescribed asthma medication, comprehensive diabetes care measures•Number of children with asthma with at least one preventive./ambulatory visit, asthma related ED visits per 1,000 member months, asthma admission rate, percent of adults with diabetes with at least one preventive/ambulatory visit, diabetes related ED visits, diabetes admission rate (some measures broken out by rural/urban, and race/ethnicity)

MCO, report also compares NM MCO's to others in the West

HEDIS and HEDIS-like measures

Overall composite score and earned designation by subject, compliance by NMAC rule


2011 One time presentation

Overall compliance score, compliance score by regulation, scores by fiscal year Plan 2011 Annually

2010 Annually

Month 2012

ER encounter data 2009 One time report

2010

Number of recipients of BCCTP program by year, number of individuals with paid claims and total expenditures by year, costs by service type

•(For Salud and COLTS adults) CAHPS measures for getting needed care, getting care quickly, how well doctors communicate, and customer service; rating of health care, personal doctor, specialist, and health plan•(For Salud Children) CAHPS measures for getting needed care, getting care quickly, how well doctors communicate, customer service, shared decision making, health promotion and education, coordination of care, rating of health plan, rating of personal doctor, rating of specialist, rating of health plan, access to prescription medicines, access to specialized services, personal doctor knows child well, getting needed information, coordination of care for children with chronic conditions•(Behavioral health) This report has many measures, and these are examples. Coming into program voluntarily, length of time receiving services from center, length of time receiving mental health services from provider, were you arrested since you began to receive mental health services, I felt free to complain, the services I received were helpful, I have become more independent

Separate reports for each MCO within each program (Salud, COLTS, Behavioral Health), broken out by adults and children. Presented in comparison to national CAHPS benchmarks.

CAHPS for Salud and COLTS, administered survey for behavioral health

All clients by county, all client by aid code, all children by aid code, all children by county, all children SCHIP by county, all native American by aid code, all native American by county, all native American children by aid code, all native American children by county, all native American children SCHIP by county

•Percent of ER visits by diagnosis category, ER utilization rate by age•Number of ER encounters by MCO, ER visit cost by age and MCO, unit cost of ER visits by MCO•ER visits by GeoAccess area, most common diagnosis groups by GeoAccess area, severity of ER visits by procedure code•Average ER visit unit cost by hospital

Average unit cost and number of visits for ER use in other sates as a comparison

•Average monthly enrollment by program•Medicaid spending by program, cost-per client by program


HEDIS 2010 Annually

Plan 2011 Once every other year


•Member enrollment by health plan, enrollment by age and gender by health plan, number of physicians and board certified physicians participating in each plan (PCPs, Ob-Gyns, pediatric physician specialists, geriatricians, other specialists), childhood immunization rates by type, plan, and year•Screening rates for breast cancer, cervical cancer, and Chlamydia; controlling high blood pressure, cholesterol management, comprehensive diabetes care, appropriate medications for people with asthma, spirometry testing, adult access to preventive/ambulatory health services, children and adolescents access to primary care providers, timeliness of prenatal care, timeliness of postpartum care, annual dental visits, call answer timeliness, call abandonment•Frequency of prenatal care, well child visits, adolescent well care visits, inpatient utilization, ambulatory care services, ER visits, inpatient utilization of non-acute care, discharges and average length of stay maternity care, average cost of prescriptions, number of prescriptions

All measures by plan, many measures by year

•Number of consumers enrolled by geographic access category, selected access measures•Standard rating by provider type, number of consumers receiving telehealth services, percentage of time access standard met in secret shopper calls, telephone responsiveness including call abandonment rate for English and Spanish callers, and answering customer service calls within 30 seconds •Performance measurement project scores by quarter, PIP scores •Provider satisfaction survey results- overall satisfaction, overall satisfaction trend, experience vs. other behavioral health care companies, service registration, claim services, and claim services trend•Consumer satisfaction survey results - ratings for adults and children and families on access, appropriateness, effectiveness, empowerment, and satisfaction by race and aggregated, total consumer and provider grievances by region and quarter, number of consumer and provider appeals•MCO financial performance metrics- medical loss ratio, administrative cost ratio, operating gain or loss•Medical loss ratio, administrative cost ratio, operating gain or loss

•Number of consumers enrolled by geographic access category, GeoAccess by provider type, consumer satisfaction with getting needed care and getting care quickly •Performance measure performance by measure, PIP ratings •Provider satisfaction measures including overall, obtaining prior authorization process, efficiency of prior authorization process, timeliness of medical director's response to concerns (the included measures differ by plan)•Consumer satisfaction with getting care quickly, getting needed care, customer service, how well doctors communicate, member participation in treatment decisions, service coordinator helpfulness, member receipt of educational materials, member use and usability of educational materials, convenience of service locations and appointment times, and the degree to which members feel they manage their day to day lives•Denial rates by MCO by quarter, combined total number of consumer and provider grievances, top six reasons for grievance, total member appeals and number overturned, total provider appeals and number overturned•Medical loss ratio, administrative cost ratio, operating gain or loss, average capitation rate by year

Provider survey, CAHPS, HEDIS, and other health plan information




Number of persons using PCO services, PCO program services 2011 One time presentation

2012 Annually

Plan 2012 Annually



•Number and distribution of SALUD! Consumers by MCO and geographic services area, GeoAccess standard score by provider type and geographic service area, satisfaction with access to prescription medicines and specialized care•HEDIS access rates- annual dental visit, children and adolescents' access to primary care practitioners, timeliness of prenatal care•Performance measurement project scores, PIP measures, number of member and provider grievances, number of member and provider appeals, number of expected appeals, ratio of filings to members •CAHPS survey results. For example, (not a complete list) getting care quickly, customer service, shared decision making, rating of personal doctor •NCQA health plan report card ratings•MCO financial performance metrics- medical loss ratio, administrative cost ratio, operating gain or loss

HEDIS, CAHPS, and other sources

Score by health plan on quality management, coordination of services, member grievance resolution, fraud and abuse, and services for CSHCN

Overall audit score by plan and program, scores by plan on individual Salud! Regulations, composite scores by regulation across all plans

PMP overall compliance score, PIP overall compliance score, PMP and PIP scores by component

MCO compliance with subcontractor certifications, MCO employee education of the false claims act, and MCO's policies and procedures concerning fraud and abuse

•Medicaid expenditures•Fraud referrals, new, closed, and open fraud cases per FY, total recoupments by entity and year, recoveries per dollar of expense, Medicaid expenditures per fraud unit staff member compared to other states, age of open referrals, percent of investigations completed in 120 days, MCO reported hard dollar recoveries



Month 2011

2012

2010 Annually

Month 2012 Monthly

Month 2012 Monthly

Year 2010 2008, 2010

•SCHIP eligible population by calendar year, average monthly enrollment, total enrolled at any time, continuously enrolled, percent continuously enrolled, number enrolled by MCO•Well child visits, adolescent well care visits, number of myringotomy procedures and tonsillectomy procedures, total inpatient discharges and days, inpatient average length of stay, ambulatory care outpatient visits, ambulatory surgical visits, observation room stays resulting in discharge, inpatient nonacute care discharges, inpatient nonacute care stays, inpatient nonacute care average length of stay, mental health inpatient discharges and average length of stay, chemical dependency inpatient discharges and average length of stay, average cost and number of prescriptions, childhood and adolescent immunization status, appropriate medications for children with asthma, annual dental visits, children's access to primary care provider

•Number of referrals, number on waitlist, number of days on waitlist, total persons placed by month, average days until placement, total caseload, total number of closed cases•Total applications received, application type, number approved and denied, average processing time, total persons in pending status, total persons placed by month, total cases, total recipients, average recipients per case, total closed cases

Medicaid -Behavioral Health Out-of-State RTC Placement for Children by principal diagnosis, states in which children are placed

Available monthly, quarterly, and as a trend

Monthly, quarterly; reports currently suspended

•Prospective drug utilization review rates: number of alerts by type, distribution of interventions by problem type, total pharmacy spending, number of recipients taking one or more drugs a month by age group•Top 10 therapeutic classes ranked by total payment amount, RX count and total payments by class, top 50 therapeutic classes units and expenditures, amount spent on selected new products

Monthly Medicaid eligibles by eligibility category, including retroactive eligibility records and those currently eligible. Number of Medicaid recipients per 1,000 Nevada residents

Number of applicant denials, number of applications by referral source, number of children by referral source, disenrollments, number enrolled by county and age, county and ethnicity, and county and health plan

All for pediatric population:•Number of members, number of members receiving any behavioral health services, percent of receiving behavioral health services, amount paid for all behavioral health services, amount paid per patient, amount paid PMPM•Number of patients, amount paid, percent of patients, and amount paid PMPM by type of service•Readmission rate for inpatient, residential, and residential to inpatient by number of days •Follow-up rate for inpatient and residential services by number of days•Number of patients using services, number of admissions, and amount paid by county for inpatient and day services



2010 One time presentation

Caseload by eligibility category and number enrolled in managed care 2007



Managed Care 2009 Annually

Antibiotic group vs. non-antibiotic group 2011 One time report

Race; gender; type of aid 2010, 2011 Annually

•Number of clients served, annual average monthly eligibles by aid group•Total Medicaid paid by type of service, expenditures by aid group, average cost per eligible, percent of overall Medicaid costs and caseload by eligibility group

Includes extracts from the FY10 Bh Ped Comprehensive Report and metrics from that report are not re-listed:•Percent of children using psychotropic drugs by age group, number taking drugs without receiving behavioral health services•For adult members: number of members, number of members receiving any behavioral health services, percent of receiving behavioral health services, amount paid for all behavioral health services, amount paid per patient, amount paid PMPM

•Total member months, and June 2011 members in managed care for Medicaid and CHIP by age and sex •Number of enrollees by MCO, ethnicity of MCO enrollees by county• Number of patients receiving services by diagnosis group, and total amount paid

Initial admissions at risk for potentially preventable readmission by admission type, thirty day potentially preventable readmission rate, average number of potentially preventable readmissions by initial admission group, top three major diagnostic categories, potentially preventable admission count by number of days between admissions and initial admission

FFS and encounter claims from New York State's Medicaid Data Mart

•Medicaid providers by specialty•Disenrollment rates and enrollment (including by aid category; sex and age)• Ratio enrollees to providers• Encounters by specialty• Output Utilization• Quality Indicators • Financial ratios (incl. premiums; admin rates etc)

•Demographic and clinical characteristics of study participants: age group, race/ethnicity, gender, aid category, health status, visit setting, provider type, cough duration, tobacco use, chest x-ray ordered, chest x-ray normal, spirometry, clinical evidence including pneumonia, documented RO pneumonia, purulent sputum, URI, advised to delay filling prescription. • Antibiotics prescribed by name and class, etc. • Documented co-morbid conditions including asthma, diabetes, hypertension, depression•Other indication or rationale for antibiotic prescribing, disposition of prescription and time to prescription fill by group

• Prevention and Well Care for Adults and Children•Behavioral Health


2009-2011


Plan 2011


Managed Care 2011

How well a health plan performed in the areas of provider network, child and adolescent health, women's health, adults living with illness, behavioral health and satisfaction with care

•HEDIS

•New York State-specific measures added to address public health issues of particular importance to New York

•CAHPS•Perinatal health measures from Department's Vital Statistics file

•Impatient hospital cost and utilization•Prescription drug cost and utilization• Medical cost trends• Overall Program effects on cost and utilization

Individuals enrolled in the HIV SNP Program

•participating HIV SNPs provided monthly medical cost and monthly inpatient claims data for over 3,700 individuals enrolled in one or more of the HIV SNPs between January 2005 and June 2007.

•The NYSDOH provided detailed fee-for-service Medicaid data for more than 30,000 PLWHAsfor September 2002 – August 2007

•Enrollment, age and sex distribution, disenrollment rates by type (voluntary, involuntary, loss of eligibility) •Number of providers by specialty, ratio of enrollees to providers, Medicaid PCP's with an open panel, Board certification rates by specialty•Primary care access survey - ability to make appointment for routine, non-urgent sick, and after hours access appointments, utilization of outpatient and inpatient services by type• HEDIS measures- engaged in care, syphilis screening, viral load monitoring •Number of citations related to appeals, number of external appeals overturned, overturned in part and upheld •Financial ratios: medical loss, premium surplus, administrative ratio, assets to net worth

Potentially avoidable at risk admissions that began an admission-readmission chain by Medicaid payment category, potentially preventable readmissions following avoidable admissions by Medicaid payment category, potentially avoidable or preventable hospital admission by Medicaid payment category, potentially preventable readmission by PQI


•Use of Services (Outpatient Utilization; Frequency of Selected Procedures; Impatient Use; Mental Health Utilization; Alcohol and Drug) •Prevention Quality Indicators; Pediatric Quality Indicators• Antibiotic Use


Managed Care 2009-2011 Annually

Managed Care 2011

2011 2006, 2011

1997-2011 Annually

1997-2011 Annually

CAHPS 2012 Once every other year

1998-2011 Annually, quarterly

Monthly

•Enrollment by Health Plan•Enrollment by County• Managed care penetration rates for each county

• Prevention and Well Care for Adults and Children•Quality of Care Provided to Members with Illnesses• Patient Satisfaction with Access and Service

• MLTC plan evaluation (e.g., plan usually or always explained services clearly, called plan with a complaint or grievance, always able to understand the answers) • Quality of Care of Providers by provider type, timeliness of care by type, access to care for regular doctor, dentist, foot doctor, eye care

Program (partial cap, PACE, MAP) and comparing 2007 vs. 2011

Survey using CAHPS and other questions

Number of Medicaid Enrollees by Category of Eligibility by each social service district and entire state: • Total Medicaid Eligibles •Medicaid and Subsistence Enrollees (for categories including TANF Children; TANF Adults; Safety Net Children; Safety Net Adults; SSI Aged; SSI Blind & Disabled)•Medicaid Only Enrollees (for categories including TANF children; TANF Adults; Safety Net Children; Safety Net Adults; Aged; Blind & Disabled; Family Health Plus; Other)

•Expenditure Report Prepaid Services Expenditures•Expenditure Reports by Type of Service•Total Prepaid Care and Managed Care (including subcategories: HMO; LTC; FHP; Mental Health); Premiums (SMI and TPHI)--by district•Total FFS and Hospital Inpatient; Hospital Outpatient; Free Standing Clinic; SNF; Child Care Per Diem; ICF DD; Physicians; Dental--by district

•Race, age, and health status of members •Health plan rating, health care rating, rating of personal doctor and specialist •Ability to get needed care, how well doctors communicate, customer service rating, ability to get care quickly

• Average Monthly Medicaid Beneficiaries for Categories of Service by Category of Eligibility•Medicaid Expenditures for Selected Categories of Service by Category of Eligibility•Medicaid Service Units for Selected Categories of Service by Category of Eligibility

Enrollment by County, Plan and Aid category


2009-2011





Mailed survey 2008 One time report

Enrollment numbers by managed care plan: •Plan Profiles • Provider Network • Child and Adolescent Health • Women’s Health • Adult Health Care • Behavioral Health • Satisfaction with Care • Preferred Provider Organizations (PPO)

•HEDIS

•New York State-specific measures added to address public health issues of particular importance to New York

•CAHPS•Perinatal health measures from Department's Vital Statistics file

Number and cost of 30 day potentially preventable readmissions, number and cost of avoidable admissions, total Medicaid inpatient discharges, total potentially avoidable hospitalizations, frequency and rate of avoidable admission by PQI

Medicaid type (FFS or managed care) and region


•Potentially preventable readmission rates by Medicaid recipient health condition at initial admission and region, potentially preventable readmission among Medicaid recipients with mental health and/or substance abuse conditions by major diagnostic category at initial admission and Medicaid payment status•Total and average costs by region, Medicaid recipient health condition, and Medicaid payment category


•Number of at risk admissions followed within 30 days followed by a potentially preventable readmission, number of potentially preventable readmissions and number FFS and managed care, rate of potentially preventable readmissions for managed care and FFS, potentially preventable readmissions by diagnostic category at admission.•Total expenditures for potentially preventable readmissions


•Selected Demographic Characteristics of the study population by region (gender, race, aid category, age)•Regional myringotomoy rates and rate ratios


This report has a large number of measures, below are examples.•Response rate by plan, comparison of respondents and non-respondents, demographic characteristics of respondents (age, gender, health status, educational level, race/ethnicity), percent with health condition by type, total number of health conditions•Access to doctors - number times went to doctor, finding a doctor- need for help, comparison of health care with care received before joining plan, comparison of specialized services before joining plan to now (ex: mobility defines, occupational therapy, speech therapy, transportation to appointments, mental health treatment)•Specialists - plan helped with care coordination, getting to specialists - need for help, if needed help got it, problems seeing a specialist because of plan•Health Plan - member services gave help needed, receipt of care management since joining plan, would recommend plan to others



2011 2010, 2011

CAHPS 2010 2008, 2009, 2010

2011 2010, 2011

2011 Monthly


Waiver type 2010 One time report

•Number of hospitalizations, age, gender, race/ethnicity of hospitalized recipients•Major diagnostic categories for Medicaid recipients by payment category for hospitalization

FFS vs. managed care, and NYC vs. rest of state


•Number of individuals enrolled, average length of time for currently enrolled consumers, number of male and female enrolls, number of enrollees by race, average age of enrollees, percent of enrollees who are full or partial duals, number of enrollees by month and eligibility category, number of enrollees by marital status, number of enrollees by county•Total program expenditures premiums paid

Ohio produces a summary overview and full reports. These reports have many measures, and below are examples.•Aged, Blind, Disabled Report - Demographic characteristics of enrollees, comparison to NCQA average for overall rating of health plan, rating of personal doctor, rating of specialist seen most often, customer service•Covered Families and Children Report - Demographic characteristics of enrollees by child and adult, health status, comparison to NCQA average for overall rating of health plan, rating of all health care, personal doctor, getting needed care, how well doctors communicate

Program (Aged, Blind, Disabled) and (Covered Families and Children) and plan

•Statewide enrollment by age, program, race and gender, waiver. Total eligibility by age, community, nursing facility or waiver, by delivery system, by program, by race, and county by waiver •Managed care enrollment by county and age, delivery system, Medicaid program, and race. FFS enrollment by county, delivery system, program, race, and waiver

Number of enrollees by month, eligibility category, county, gender, race, marital status, and age•By category of service, statewide summary of claims paid, number of providers, and total expenditures by month (also available at the county level by county of provider and county of consumer)•Total capitation payments statewide per month, total capitation payments per county per month, FFS expenditures by category of service and paid date

This report has a large number of measures and the following are examples:•Participants who reported having input on their services, percent of identified needs addressed, participants who knew they could chose their providers•Number of participants for whom reported incidents were examined, number of participants for whom unreported incidents were discovered, types of incidents participants reported to case managers•Number of participants indicating they received information about hearing rights, participant satisfaction with their case manager•Cost per member per month by service type



2012 Monthly

Plan 2006 Annually for 2006 and earlier

2003 Annually for 2003 and earlier

Waiver type 2011 One time report

2012 Quarterly

Number of clean claims processed to final status in 30 and 90 days by health plan 2011 Twice a Year

•Frequency of SSA contact, person who determined what services would be best, number of records with a strategy for addressing a behavior by behavior type•Living arrangements of individuals, guardianship status, age distribution of individuals, length of time individuals were on waiting list for waiver, individual satisfaction with residential staff, where you live, your day program, where you work, your SSA, your daily representative, and your waiver services•By category of service and IO waiver service: number of individuals receiving services, percent who received service, cost per member per monthStatewide health care plan enrollment by method (phone, face to face, mail, website, call campaign) and type (FFS to MCP, MCP to MCP), region, plan, and by voluntary enrollment or assignment by region.

Initiation of prenatal care, frequency of ongoing prenatal care, cesarean section rate, low birth weight rate, very low birth weight rate, postpartum care, well child visits, annual dental visit, lead testing, use of appropriate medication for people with asthma, comprehensive diabetes care

Appear to be CAHPS measures, but the methods do not state this

•Average managed care enrollment•Average Medicaid eligibles by month•Satisfaction with health plan, satisfaction with clinical care, voluntary disenrollment reasons, complaint reasons, ease in finding a doctor or nurse, getting needed care, PCP capacity, physician turnover rates, adults access to primary care, children's access to PCP•Annual dental visit rate, inpatient hospital discharges, outpatient hospital visits, frequency of ongoing prenatal care, well child visits, asthma medication management•Managed care plan administrative expense ratio and overall expense ratio

This report has a large number of measures and the following are examples:•Number of level of care (LOC) determinations and redeterminations completed timely, percent of participants with LOC appropriate for waiver, participants who reported having input on their services, percent of identified needs addressed, participants who knew they could chose their providers•Percent of annual provider reviews completed on time, number of participants for whom reported incidents were examined, number of participants for whom unreported incidents were discovered, number and rate of adverse outcomes •Number of participants indicating they received information about hearing rights, participant satisfaction with their case manager, number of participants authorized to receive services who received at least one service

•Expenditures by category and compared to projections•Number of covered families and children, number of aged, blind, and disabled enrollees



Enrollment numbers by county, age, race, and gender County, age, race, and gender Current as of Spring 2012 Monthly

CAHPS 2010

SoonerCare delivery count July 1, 2010 through June 30, 2011 2011 Annually



CAHPS 2009

2011 Quarterly

HEDIS and CAHPS 2009 One time report

2011 Quarterly

•Provider count by program, by county•Member to provider ratio by county

Ratings for: Experiences in Getting Treatment Quickly; Experiences with How Well Clinicians Communicate; Experience with Getting Needed Care; Experience with Information and Customer Service

•Total SoonerCare enrollment•Number of behavioral health providers; reimbursement by month•Numbers of members served and average dollars per member by category of service

•Nursing facility participation; CNA student monthly applicants; fully trained and certified students since inception•Number of SoonerCare members residing in nursing facilities (by gender)

Ratings for: Experiences in Getting Treatment Quickly; Experiences with How Well Clinicians Communicate

Quarterly SoonerCare Choice ER utilization; High ER use members by age; Total ER visits and high ER use members This report has a large number of measures and the following are examples:•SoonerCare average monthly enrollment by Medicaid eligibility group; estimated Medicaid participation rates•HEDIS and CAHPS measures for access to care•SoonerCare choice PCPs by type and region; SoonerCare choice PCP participation rates among primary care specialists•HEDIS measures •Per-enrollee Medicaid expenditures and average annual growth rate by eligibility group; percentage of total state expenditure on Medicaid•Oklahoma SoonerCare plus MCO regions and years of service

•Provider participation in focus on excellence, the OHCA program for Oklahoma nursing home ratings•Long-Term Care (LTC) members residing in nursing facilities by gender, race, and age


HEDIS 2011 Annually


Age, race, urban/rural Current as of Spring 2012 Monthly


Current as of Spring 2012 Annually

TEFRA current enrollment by gender, race Current as of Spring 2012 Monthly

Varies: 2002-2010

Type of Service Current as of Spring 2012 Annually, twice a year

Sponsor Type 2008 Previous reports in 2002, 2004

HEDIS measures including: Annual dental visit, women's cancer screenings, child health checkups, access to care, diabetes, asthma, lead screening, respiratory and cardiovascular conditions

•Capitation rate per SoonerCare member; capitation rate per dual member •PACE enrollment by gender, race (American Indians or all other races); age breakdown

Enrollment numbers by age, race, urban/rural in SoonerCare Choice (a PCMH program)

Monthly Total Home and Community-Based Services Waivers Enrollment; Program Breakdown by Gender; Total HCBS Waivers Enrollment Race Breakdown; Program Breakdown by Race

This report has a large number of measures and the following are examples:•SoonerCare (OK Medicaid) enrollees by county as a percent of the total estimated 2010 OK population; coverage by age, race, blindness and disability, or dual eligibility•Post-payment review recoveries, in dollars, by provider type •Expenditures by type of service

This is a webpage that contains various SoonerCare-related surveys, studies, and reports, including member satisfaction surveys, evaluation reports for SoonerCare, studies and reports on care and access.

•Reimbursement rates for OHP managed care plans•Average per person health care costs

Ratings and percentages for getting needed care, getting care quickly, how well doctors communicate, health plan information & customer service


2010 Previous reports in 2004, 2006

Age, race/ethnicity, gender Current as of Spring 2012 Monthly

Eligible clients by program and county Program, county DMAP-DSS warehouse Current as of Spring 2012 Monthly

DMAP-DSS warehouse Current as of Spring 2012 Monthly

HEDIS measures Plan HEDIS

HEDIS measures Plan HEDIS 2011

2011

CHIP enrollment figures County Current as of Spring 2012 Monthly

Medical Assistance (MA) monthly enrollment data Adult and children Current as of Spring 2012 Monthly

This report has a large number of measures and the following are examples:•Acceptance of Medicaid by specialty•Factors contributing decision to limit Medicaid•Physician satisfaction•Access to services to OHP patients by type of service

Distribution of age, race/ethnicity and gender among clients on the Oregon Health Plan

Enrollments for fully capitated health plans (FCHPs), primary care case managers (PCCMs), dental care organizations (DCOs) and mental health organizations (MHOs)

County, eligibility group, capitation rate group

HealthChoices and Rate Charts: 2011

HealthChoices and Rate Charts: Annually

Percentage ratings for health care in last six months, personal doctor, getting health care from specialists, health plan, about you (and your child)

Adult CAHPS and child CAHPS; Access Plus (for those not enrolled in voluntary managed care in counties not serviced by HealthChoices) and HealthChoices (Medicaid managed care)


2010 One time reportThis report has a large number of measures and the following are examples:•Number of children with disabilities enrolled in managed care, FFS•Total MA expenditures; average cost per member per month; FFS expenditures by service category•Managed care capitation payments


2009-2010 Annually

2003

This report has a large number of measures and the following are examples:•Medical Assistance eligibles•Medical Assistance expenditures•Number of new provider applications processed; number of FFS claims processed annually•Number enrolled in HealthChoices (mandatory managed care program), voluntary managed care program, ACCESS Plus (Enhanced Primary Care Case Management Program)•HEDIS performance results by measure

This report has a large number of measures and the following are examples.

•Total child and adolescent FFS Medicaid recipients by age, sex, and eligibility type, number of hospital stays and ED visits with a mental disorder as the principal diagnosis by age and sex, percent of children and adolescents with hospitalizations by diagnoses, percent of children and adolescents with ED visits by diagnoses, percent of children and adolescents with repeat ED visits by diagnoses, hospital use and expenditures by diagnosis physical vs. mental for recipients with at least one hospital stay.

•Total working age adults in FFS Medicaid by age and sex, hospital stays and ED visits by mental order principal diagnosis age, and sex, leading causes of hospitalization by principal diagnosis for FFS Medicaid recipients ages 21-64, percent of working-age adults with repeat hospitalizations by diagnoses, hospital use and expenditures by diagnosis for recipients with at least one hospital stay.

MMIS claims based data extracts


By year for 1998, 1999, and 2000 2002

Survey 2002

Member satisfaction, in percentages, with the RIte Care Program Survey 2008 Previous reports in 2004

HCBS “Snapshot” Survey 2010 One time report

•Characteristics of working age FFS Medicaid enrollees by age, sex, and race, total hospital stays (total days and rate), rate of of ED use, hospitalization rates by gender, ED utilization rates by gender, hospitalization rates by race, ED utilization rates by race, leading causes of hospitalizations by principal diagnosis, leading causes of mental disorders as principal diagnoses for hospitalizations, leading causes of emergency department visits by principal diagnosis, leading causes of mental disorders as principal diagnoses for emergency department visits, occurance and frequency of hospitalization and emergency department visits, percent of enrollees with hospitalizations by number of hospitalizations, percent of enrollees with emergency department visits by number of ED visits, percent of enrollees by hospital and ED utilization.

•Number of hospital stays and rate per 1,000 eligible persons, number of ED visits and rate per 1,000 eligible persons by age, sex, and race, number of hospital stays and emergency department visits by principal diagnosis, number of hospital stays and emergency department visits by mental disorders as principal diagnosis, of those with hospitalizations number with one/two/three/etc. hospitalization, of those with emergency department visits number with one/two/three/etc. visits, number of hospital stays and rate per 1,000 eligible persons, number of ED visits and rate per 1,000 eligible persons by age, sex, and race, number of hospital stays and emergency department visits by principal diagnosis, number of hospital stays and •Demographic and social characteristics of survey respondents, living arrangements of respondents, average number of days a week leave home, number of health conditions per respondent, number of health conditions by age, distribution of health conditions, distribution of health conditions by gender, number of years with health conditions, most serious health problems in the past year, prevalance of major types of health conditions (ex. heart conditions, asthma, diabetes), health status of adults with disabilites on FFS Medicaid, percent of respondents experiencing pain, depression, and anxiety every day of the past month, usual place of medical care, have own doctor and number of yearly visits, see other doctors/specialists and number of yearly visits, needed immediate medical care in past year, place for receiving acute medical care by having own doctor, number of ED visits in the past year, number of hospital admissions/nights spent in the hospital, for those with a hospital admission, number of nights spent in a hospital in past year,

•Number and percent receiving preventive health care services, health care screening services in past year by whether you have your own doctor, cancer screenings in past year by whether you have your own doctor, number and percent taking prescription medications, for those taking prescription medications number who had a problem obtaining them in past year, need for assistance with the activities of daily living and the extent of unmet needs, need for assistance with the instrumental activities of daily living and the extent of unmet need.

•Percent of respondents needing services by service type (ex. dental care,

This link also includes other LTC-related reports for year 2010•Percent of HCBS recipients who got care providers they needed; who got mobility equipment they needed; who got home accommodations they needed; who got medical supplies they needed; who got other support services they needed•Satisfaction with Medicaid program, in percentages•Adults enrolled in aged and disabled waiver




2012 Quarterly

RIte Share gross and net savings; savings on PMPM basis Year 2006 One time report


Performance category HEDIS and CAHPS 2011 Annually

HEDIS 2011

This report has a large number of measures and the following are examples. This link also includes other LTC-related reports for year 2011.•The average percent of new admissions with stays >90 days; short-term memory problem by new admission cohorts; transfer--need extensive/total assistance in past 7 days by long stay cohorts•Distribution of RI nursing home residents with Medicaid nursing home claim in 2008 and 2010

This report has a large number of measures and the following are examples. This link also includes other LTC-related reports for year 2011.•Mood patterns by long stay admission cohort; ADLs by long stay admission cohort; received psychotropic medications in last 7 days by long stay admission cohort•Distribution of RI nursing home residents with Medicaid nursing home claim in 2008

This report has a large number of measures and the following are examples:•Medicaid long-term care acceptance (approvals), by month for Q1 of 2012; number of Medicaid beneficiaries served in institutional and community-based long-term care settings•Average cost per individual, by service type

This is a long report; below are just some examples. This link also includes other LTC-related reports for year 2010. •Provider types included in provider survey•Number of respondents serving each county in Rhode Island, by provider type•Number of survey respondents serving Medicaid clients

HEDIS and CAHPS measures in RIte Care (RI's Medicaid managed care program) and Rhody Health Partners (State's Medicaid managed care program that serves adults with disabilities and chronic conditions who are not eligible for Medicare or other health insurance coverage)

This report has a large number of measures and the following are examples:•Enrollment number•Medicaid managed care performance on HEDIS quality measures•Percent of total Medicaid expenditures; average per member per month•Percent of Medicaid eligibles enrolled in managed care plans

Previous reports in 2002-2005, 2006, 2008




Insurance coverage 2006 One time report


Plan MMIS




•Rite Care enrollment trend (including Rite Share)•Rite Care expenditures

This report has a large number of measures and the following are examples:•RIte Care enrollment, by plan; RIte Share enrollment; member satisfaction•ED utilization; inpatient and outpatient visits•CAHPS measures•Screening, immunization rates, child outcomes, etc.

Characteristics of mothers; prenatal care; maternal health birth outcomes; teen pregnancy

This report has a large number of measures and the following are examples; also includes other LTC-related reports for year 2008-2009:•HCBS payments by provider type•Recipients and HCBS spending by age group; HCBS as a percentage of long-term care spending; histogram of HCBS spending by client

•Managed care enrollment by county•Number opting in and out of managed care, and why

Enrollment statistics: Current as of Spring 2012Enrollment snapshot: 2011

•Total member months in FFS, MCO, and MHN•FFS claims expenditures•South Carolina Report Card (This is a large list of statistics, I provide only examples): annual dental visits children, lead screening, breast cancer screening, postnatal care visits, getting needed are quickly, doctors communicate well with patients

HEDIS and CAHPS, claims data

Total member months in FFS, MCO, and MHN

FFS claims expenditures

South Carolina Report Card (This is a large list of statistics, I provide only examples): annual dental visits children, lead screening, breast cancer screening, postnatal care visits, getting needed are quickly, doctors communicate well with patients

HEDIS and CAHPS, claims data

Number of fraud cases opened, amount recovered from providers, amount covered from other program integrity cases, number of convictions, number of pharmaceutical cases with recoveries, amounts recovered for pharmaceutical recoveries




Category of service Current as of Spring 2012

Aid and service category 2012 Annually

TennCare (State of TN's Medicaid program) enrollment data by county, sex, age 2011 Monthly until November 2011

Overall and by plan HEDIS and CAHPS 2011 Annually

Current as of Spring 2012 Quarterly

2010 Twice a year until 2010

Annually until 2008-2009

2011 Annually

Women HEDIS 2010 Annually until 2010

Total trips provided by type of transportation, number of calls, number of complaints by type, total number of denials by type

•Medical eligibles and recipient data, by population group, by county•Recoveries and fraud investigation collections, by program type

Annual Statistical Report: 2011Monthly Statistical Report: Current as of Spring 2012

Annual Statistical Report: AnnuallyMonthly Statistical Report: Monthly

•Number of persons eligible for medical services, by population group•Total monthly managed care enrollment

•PMPM of various population groups and CHIP•PMPM and utilization for inpatient, outpatient, evaluation and management, spec physician services, medical expenses, other, pharmacy•Total claim expenditures for ER, recipients

•TennCare medical per member cost; dental per member cost; pharmacy per member cost; dominant disease categories; long-term care per member cost•Physician reimbursement; hospital provider cost analysis

This report has a large number of measures and the following are examples:•Access of care measures (e.g. call answer timeliness) under HEDIS•CAHPS measures for satisfaction with the experience of care•Effectiveness of care measures (e.g. screening) under HEDIS

•Number of recipients on TennCare•Cost of TennCare to the state•Cases of abuse received; court fines and costs imposed

•Provider network distance and appointment time standards by type of service•HCBS enrollment

This report has a large number of measures and the following are examples:•TennCare expenditures by category; TennCare eligibility chart by income; TennCare expenditures and recipients by category; long term care services by number of providers, recipients, and average expenditure per recipient•Enrollment in managed care organizations; MCO medical expenditure by category of service

This report has a large number of measures and the following are examples:•Average wait time for appointments, in minutes•Consumer satisfaction with TennCare, in percent

This report has a large number of measures and the following are examples:•Breast and cervical cancer screening (HEDIS)•Utilization of services for physician visits, ED visits, hospitalizations, ambulatory care sensitive conditions



HEDIS 2009 Annually until 2008

2011

Medicaid application and redetermination timeliness Current as of Spring 2012 Monthly



2012 Annually

2011 Annually

Plan HEDIS 2012 Annually


•Enrollment by county and month•Enrollment by county and month•Enrollment by month

This report has a large number of measures and the following are examples:•HEDIS measure of children and adolescent access to primary care providers•HEDIS measures for well-child visits, adolescent well-care visits, follow-up after hospitalization for mental illness

FY 2009 Medicaid Improper Payment Rates for Texas for FFS, managed care, eligibility with undetermined, combined rate, eligibility without undetermined, combined rate without undetermined

Monthly enrollment, new enrollment by service area and health plan for Medicaid managed care

This is a long survey completed by providers. It includes yes or no responses to statements such as "I receive timely authorizations or prior authorization when needed," "My claims are paid timely," and "I receive notification when my patients are treated in a hospital Emergency Department."

This report has a large number of measures and the following are examples:•Medicaid inpatient hospital utilization and payments by care category•PPR rates overall by Medicaid care category, APR-DRG•Top 20 APR-DRGs in terms of total readmissions

This report has a large number of measures and the following are examples:•Various figures and tables on enrollment•Percent enrolled in managed care•Overall cost of program

This report has a large number of measures and the following are examples:•Prenatal and postpartum care; HEDIS adult access to preventive/ambulatory health services•Well-child visits in 3rd, 4th, 5th, 6th years of life; adolescent well-care visits; HEDIS ambulatory care•Effectiveness of care under HEDIS

This report has a large number of measures and the following are examples:•Prenatal and Postpartum Care, and Children and Adolescents’ Access to Primary Care Practitioners•Well-Child Visits in the First 15 Months of Life, Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life, Adolescent Well-Care Visits, and AHRQ Pediatric Quality Indicators (PDIs) and Adult Prevention Quality Indicators (PQIs)•Effectiveness of care under HEDIS


2011 Annually

CAHPS 2007 One time report

CAHPS 2007 One time report

Plan HEDIS 2011 Annually

Plan CAHPS 2011 Annually

2011 Annually

2011 Annually

Amount recovered in Medicaid costs and future cost avoidance 2012 Annually

This report has a large number of measures and the following are examples:•Prenatal and postpartum care; children and adolescents' access to primary care practitioners•Frequency of Ongoing Prenatal Care, Well-Child Visits in the First 15 Months of Life, Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life, Adolescent Well-Care Visits, HEDIS® Ambulatory Care, AHRQ Pediatric Quality Indicators, and HEDIS® Mental Health Utilization•Effectiveness of care under HEDIS

This report has a large number of measures and the following are examples:•Physician availability and communication • Enrollee satisfaction with program

This report has a large number of measures and the following are examples:•Family experiences and satisfaction with their child's health care

This is a webpage with many tables and graphs; below are some examples:•HEDIS measures for access to health care•HEDIS measures for immunizations, child and adolescent health care, use of medications, etc.•Monthly enrollment in Medicaid and CHIP HMOs

CAHPS survey that asks CHIP and Medicaid members to rate their health plan, health care, doctor, and specialist; as well as components such as getting care quickly, getting needed care, doctor communication, and customer service

•Eligibility and enrollment statistics by age, race, income•Well-child visits in the first 15 months of life; Well-child visit in children the 3rd, 4th, 5th and 6th years of life; Children’s access to primary care practitioners.

This report has a large number of measures and the following are examples:•Enrollment statistics for Medicaid and CHIP by age, race, sex•Number of participating FFS providers by category of service•Various tables on expenditures by category of service; by nursing home and HCBS waiver expenditures•Managed health care eligible-client distribution by health plan, rural program, and FFS



2012

Age, Race 2011 Annually

Age, Race 2011 Annually

Plan HEDIS and CAHPS 2010 Annually

2010 Annually

2010 Annually

2011 Annually

•Enrollment percentages in Medicaid by population group•Percentages of total Medicaid expenditures by major eligibility categories; average cost of selected imaging procedures; annual visits and charges for several health care system measures

•Caseload size (by demographic group)•Expenditures (by type of optional service)

Overall ratings of personal doctor, specialist, health care and Medicaid plan; percentage ratings for getting needed care, getting care quickly, how well doctors communicate, customer service, shared decision-making, health promotion and education, coordination of care

Overall ratings of personal doctor, specialist, health care and Medicaid plan; percentage ratings for getting needed care, getting care quickly, how well doctors communicate, customer service, shared decision-making, health promotion and education, coordination of care

HEDIS scores for 14 measures such as cholesterol management, diabetes care, well-child visits, prenatal and postpartum care; comparison of VA Medicaid MCO scores and national Medicaid Managed Care average for HEDIS and CAHPS

This report has a large number of measures and the following are examples:•Trends in women receiving adequate care•Specific Medicaid program populations•Trends in overall low birth weight rates; overall low birth weight rates by FFS, MCO, and PCCM delivery systems in CY 2007 through CY 2009 as Compared to the CDC/NCHS National Vital Statistics Systems (NVSS) averages

This report has a large number of measures and the following are examples:•Well-child visits by age groups for all programs•Children aged 24 months who received all required components of the Combinations 2 and 3 immunization series•Children diagnosed with persistent asthma, who were prescribed medication for asthma•Children and adolescents who had a visit with a primary care practitioner (PCP) during 2009

•Member experience with Medicaid managed care•Percent of enrollees in managed care




Expenditures (total, PMPM) Type of coverage 2013 Annually

Enrollment numbers Type of coverage, gender, and county Current as of Spring 2012 Monthly

HEDIS 2010 Annually

2010 Annually

Plan CAHPS 2007 One time report

Treatment and control CAHPS 2008 One time report

2011, 2012

2010

Approved slots, current enrollment, current waitlist numbers for elderly or disabled with consumer direction (EDCD), mental retardation/intellectual disabilities (MR/ID), DD+, technology assisted (TECH), Day Support, ALZ, AIDS.

•Number enrolled in Virginia Medicaid, by population type•Medical expenditures by delivery type and LTC•Percent of total beneficiaries enrolled in managed care

This report has a large number of measures and the following are examples:•Immunizations, well-child care visits, diabetes care, postpartum care, and many other quality and outcomes measures under HEDIS; •Washington Medicaid Integration Partnership (WMIP) comprehensive diabetes care and utilization measures for ambulatory care visits, inpatient

Plan, type (acute, non-acute, medical, surgery)

This report has a large number of measures and the following are examples:•Washington scores and national averages for physical health access and timeliness measures; MCO and state scores for physical health access and timeliness measures•CAHPS measures for physician communication•See line for 'access to care'; diabetes care measures•Utilization levels for acute care, by total inpatient, medical, and surgical•Number of Medicaid enrollees in managed care, by plan; map of Healthy Options/CHIP service areas

Measures for getting needed care, getting care quickly, how well doctors communicate, customer service, shared decision making, overall satisfaction ratings

Measures for getting care that is needed, getting care without long waits, how well doctors communicate, how people rated their health care, how people rated their personal doctor or nurse, how people rated the specialist they saw most often

•Number of adults and children enrolled in Medicaid•Number of adults and children enrolled in FFS and managed care

•County, program•Program

State presentation on program integrity:•Number of providers, by provider types; total amount paid to each provider type•Percent of total providers audited, by provider types; total amount recovered in year; savings resulted from DSHS payment review program


Enrollment numbers by county County Current as of Spring 2012 Monthly

Number of members enrolled in MCOs Month and county Current as of Spring 2012 Monthly

Population group and MCO Current as of Spring 2012 Monthly

Plan CAHPS 2009 Once every other year until 2008


Plan HEDIS 2010 One time report

2011

2011

Number of Medicaid eligibles County Current as of Spring 2012 Monthly

Monthly enrollment numbers for MCO Plan Current as of Spring 2012 Monthly

Medicaid expenditures Provider type 2012


Medicaid Top 10 Claim Errors, in percentages 2012

•Enrollment numbers by population group (including BadgerCare Plus, or Wisconsin CHIP)•Enrollment numbers by MCO

Overall ratings for getting needed care; getting care quickly; doctor communication; helpfulness of office staff; customer service; health plan; health care

Percent ratings for customer service, getting needed care, health plan, and health care

This report has a large number of measures and the following are examples:•Adults' access to preventive/ambulatory health services; annual dental visit•Effectiveness of care measures such as lead screening in children; breast cancer screen; cervical cancer screening.•Mental health utilization; outpatient drug utilization

This report has a large number of measures and the following are examples:•Number of medical assistance recipients•Overall medical assistance expenditures; monthly capitation rates per recipient, by subprogram; fee-for-service expenditures for elderly and disable, recipients enrolled in managed care subprograms•Reported investigations of medical assistance eligibility; reported financial recoveries of medical assistance costs for ineligible recipients

•Plan enrollment•Basic plan revenue and expenditure; average monthly costs for basic plan; claims incurred by basic plan enrollees

•Total CHIP and Medicaid enrollment, by county•Total CHIP and Medicaid enrollment, by qualifying income and age

Current Enrollment: Current as of Spring 2012Annual Enrollment: 2011

Current Enrollment: MonthlyAnnual Enrollment: Annually

Total WV EHR PIP payments to date, hospital count, hospital amount, eligible healthcare professional count, eligible healthcare professional amount


2011 Annually

Number of Medicaid births by county 2011 Annually

Eligibility overview; Wyoming Medicaid enrollment, by population group Population group 2009 One time report

Number of children enrolled in Kid Care CHIP 2012

2007

This report has a large number of measures and the following are examples:•Eligible individuals by program category, county; number of Medicaid recipients by service area•Medicaid expenditures by eligibility category; expenditures by type of service; expenditures per recipient by eligibility category•Number of recipients of home health services; expenditures per recipient of home health services; number of recipients of LTC; expenditures per recipient of LTC•Number of providers and expenditures by provider type•Number of integrity cases opened, amount of claims reviewed, number of providers recovered, and amount recovered by provider type

Vital Records Office andMMIS COLD Report WYO0210-R004; MMIS COLD Report WYO0210-R002

•Kid Care CHIP participants by family income•Health services used by Kid Care CHIP enrollees by number of services and number of children served; Kid Care CHIP appropriations and expenditures (overall)

Document Author Link(s) to Data

Alaska Legislature

Alaska Legislature

Alaska Legislature

http://www.hss.state.ak.us/perm/

Division, Office, or Website Section Under Which Data are Posted

Alaska Department of Health and Social Services, Office of the Commissioner

Tammy Sandoval and Bill Hogan

http://www.hss.state.ak.us/publications/

Representative Mike Hawker’s Office

http://www.google.com/url?sa=t&rct=j&q=medicaid%20site%3Alegis.state.ak.us&source=web&cd=11&ved=0CFQQFjAAOAo&url=http%3A%2F%2Fwww.legis.state.ak.us%2Fbasis%2Fget_documents.asp%3Fsession%3D26%26docid%3D3581&ei=MiLMT__GOM636QGw37Ag&usg=AFQjCNEjgyuzsr2DY1b-O29-yTO4aNlHgA&cad=rja






The Lewin Group and ECONorthwest

http://www.hss.state.ak.us/publications/publications2.htm

http://www.google.com/url?sa=t&rct=j&q=medicaid%20site%3Alegis.state.ak.us&source=web&cd=7&ved=0CGUQFjAG&url=http%3A%2F%2Fwww.legis.state.ak.us%2Fbasis%2Fget_documents.asp%3Fsession%3D26%26docid%3D5820&ei=VmrFT-_yMNCu6gHn1-2fBg&usg=AFQjCNGt1DQJE9rxwmPFgd7DwtlZH89Otg&cad=rja

Alaska Department of Health and Social Services

http://www.google.com/url?sa=t&rct=j&q=medicaid%20site%3Alegis.state.ak.us&source=web&cd=1&ved=0CFkQFjAA&url=http%3A%2F%2Fwww.legis.state.ak.us%2Fbasis%2Fget_documents.asp%3Fsession%3D27%26docid%3D1091&ei=VmrFT-_yMNCu6gHn1-2fBg&usg=AFQjCNGzsJJ6E78NaV60FYV5IoEsjysbeA&cad=rja

Alaska Department of Health and Social Services




http://www.hss.state.ak.us/publications/publications2.htm

Document Author Link(s) to Data Division, Office, or Website Section Under Which Data are Posted

Alaska Health Care Commission

Alabama Medicaid Agency

Arkansas Legislature

Arkansas Medicaid




http://www.hss.state.ak.us/commissioner/legislature/

Alabama Department of Public Health

http://adph.org/allkids/Default.asp?id=580

http://medicaid.alabama.gov/CONTENT/2.0_Newsroom/2.6_Statistics.aspx

Arkansas Advocates for Children and Families

http://www.arkleg.state.ar.us/bureau/research/Publications/Task%20Forces/Legislative%20Task%20Force%20on%20Reducing%20Poverty%20and%20Promoting%20Economic%20Opportunity;%20and%20for%20Other%20Purposes/Task%20Force%20Meetings/2010-05-26/Handout%20-%202010%20Crossing%20the%20Finish%20Line%20-%20Moving%20Towards%20Covering%20All%20Children.pdf

•Presentation and handout: Eugene Gessow•Others: Not applicable

https://www.medicaid.state.ar.us/InternetSolution/provider/costcurve.aspx


http://www.hss.state.ak.us/commissioner/legislature/

http://adph.org/allkids/Default.asp?id=580

http://medicaid.alabama.gov/CONTENT/2.0_Newsroom/2.6_Statistics.aspx

https://www.medicaid.state.ar.us/InternetSolution/provider/costcurve.aspx


Arkansas Medicaid

Arkansas Medicaid Eugene Gessow


Arkansas Medicaid Chuck Shelnutt

Arkansas Medicaid

https://ardhs.sharepointsite.net/DMS%20Public/Forms/AllItems.aspx?RootFolder=%2fDMS%20Public%2fMedicaid%20Transformation%2fArkansas%20Medicaid%20Structured%20Data%20Sets&Folder

Arkansas Department of Human Services

https://ardhs.sharepointsite.net/HCBS/Annual%20Reports/Forms/AllItems.aspx

https://www.medicaid.state.ar.us/InternetSolution/General/reports.aspx

Department of Human Services, Division of Medical Services

http://www.arkleg.state.ar.us/assembly/2011/Meeting%20Attachments/430/I10324/Medicaid%20Report-3rdQuarter.pdf


https://www.medicaid.state.ar.us/InternetSolution/general/anreps/choose.aspx

https://ardhs.sharepointsite.net/DMS%20Public/Forms/AllItems.aspx?RootFolder=%2FDMS%20Public%2FMedicaid%20Transformation%2FArkansas%20Medicaid%20Structured%20Data%20Sets&Folder

https://ardhs.sharepointsite.net/HCBS/Annual%20Reports/Forms/AllItems.aspx





AHCCCS

AHCCCS

Healthy Families Program

Healthy Families Program

Center for Business and Economic Research, Sam M. Walton College of Business, University of Arkansas

http://www.arkleg.state.ar.us/assembly/2011/Meeting%20Attachments/430/I8226/Exh%20E%20%20Medicaid%20Spending.PDF

Arizona Health Care Cost Containment System (AHCCCS) Administration

•ALTCS Member Satisfaction Survey- Synovate Public Sector and Healthcare Services Research Group•Member Satisfaction Survey (AHCCCS)- WB&A Market Research•Provider Satisfaction Survey- Center for Health Information and Research, Arizona State University

http://www.azahcccs.gov/shared/surveys.aspx?ID=research


http://www.azahcccs.gov/reporting/enrollment/AHCCCSBirths.aspx


http://www.azahcccs.gov/reporting/transparency/Default.aspx


•http://www.azahcccs.gov/reporting/oversight/acute.aspx

•http://www.azahcccs.gov/reporting/oversight/contractor.aspx


Health Services Advisory Group (HSAG)

http://www.azahcccs.gov/reporting/reports/EQR.aspx

http://www.healthyfamilies.ca.gov/Plans_Providers/Health_Plan_Quality_Measures/

http://www.healthyfamilies.ca.gov/Plans_Providers/How_Members_Rate_The_Plans/

California Department of Health Care Services

http://www.dhcs.ca.gov/dataandstats/reports/Pages/MCalDrgUtilData.aspx

http://www.azahcccs.gov/shared/surveys.aspx?ID=research

http://www.azahcccs.gov/reporting/enrollment/AHCCCSBirths.aspx

http://www.azahcccs.gov/reporting/transparency/Default.aspx

http://www.azahcccs.gov/reporting/reports/EQR.aspx

http://www.healthyfamilies.ca.gov/Plans_Providers/Health_Plan_Quality_Measures/

http://www.healthyfamilies.ca.gov/Plans_Providers/How_Members_Rate_The_Plans/

http://www.dhcs.ca.gov/dataandstats/reports/Pages/MCalDrgUtilData.aspx


Office of the State Auditor



Mercer


California Department of Health Care Services

CA Research and Analytic Studies Section (RASS)

http://www.dhcs.ca.gov/dataandstats/statistics/Pages/RASB_Default.aspx

Colorado Department of Health Care Policy and Financing


http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1212398231002

Colorado General Assembly, Office of the State Auditor

http://www.leg.state.co.us/OSA/coauditor1.nsf/All/F97A55EF56344E3A8725754D006DF2E8/$FILE/1914%20Medicaid%20LongTermCareServJan2009.pdf


http://www.leg.state.co.us/OSA/coauditor1.nsf/All/D6A75E733F7DF72B872574F6007A630C/$FILE/1908%20CHP%20Perf%20Audit%20Oct%202008.pdf


http://www.leg.state.co.us/OSA/coauditor1.nsf/All/609DAF66579EBF62872574640057F6EE/$FILE/1844%20CBHP%20Perf%20May%202008.pdf


http://www.leg.state.co.us/OSA/coauditor1.nsf/All/C5D591464946E9068725765E005D26CD/$FILE/1900MedicaidDMEContrOct2009.pdf


http://www.leg.state.co.us/OSA/coauditor1.nsf/All/6DD04E82D6D8004F872575F2005FECC2/$FILE/1832%20Dev%20Dis%20Perf%20June%202009.pdf

Colorado General Assembly, Colorado Legislative Council Staff

Colorado Legislative Council Staff

www.leg.state.co.us/CLICS/CLICS2012A/.../120201AttachA.pdf


http://www.leg.state.co.us/OSA/coauditor1.nsf/All/D6A75E733F7DF72B872574F6007A630C/$FILE/1908%20CHP%20Perf%20Audit%20Oct%202008.pdf

http://www.leg.state.co.us/OSA/coauditor1.nsf/All/C5D591464946E9068725765E005D26CD/$FILE/1900MedicaidDMEContrOct2009.pdf

http://www.leg.state.co.us/CLICS/CLICS2012A/.../120201AttachA.pdf



Clifton Gunderson LLP

MAXIMUS

Mercer


The Caley Gordon Group

Husky Healthcare

Husky Healthcare

Connecticut Legislature Yale School of Public Health


http://www.leg.state.co.us/OSA/coauditor1.nsf/All/86A3BF28FAC66DF5872578950060D5C1/$FILE/2134%20MedicaidPediatricHospiceWaiverPerfMay2011.pdf




http://www.leg.state.co.us/OSA/coauditor1.nsf/All/5AE33A6CD71E55BA87256F6A006C1039/$FILE/1636%20Medicaid%20Claims%20Perf%20Dec2004.pdf




http://www.leg.state.co.us/OSA/coauditor1.nsf/All/8E6CDA5BBC1EDC8B87257241006DCA83/$FILE/1754%20Medicaid%20MH%20Rates%20rel%20Dec%202006.pdf


http://www.leg.state.co.us/OSA/coauditor1.nsf/All/80EE029745B4C589872577F30060F888/$FILE/2079SubstanceAbuseFinalReport12132010.pdf


www.leg.state.co.us/.../1637%20HCPF%20Medicaid%20Prescription....Similar

http://www.huskyhealth.com/hh/cwp/view.asp?a=3573&q=424468


http://www.cga.ct.gov/ph/medicaid/mmcc/special/Report_HUSKY%20Report%20Card%20Investigation.pdf

http://www.leg.state.co.us/OSA/coauditor1.nsf/All/86A3BF28FAC66DF5872578950060D5C1/$FILE/2134%20MedicaidPediatricHospiceWaiverPerfMay2011.pdf



http://www.leg.state.co.us/.../1637%20HCPF%20Medicaid%20Prescription....Similar



http://www.cga.ct.gov/ph/medicaid/mmcc/special/Report_HUSKY%20Report%20Card%20Investigation.pdf


Connecticut Legislature Connecticut Voices for Children

Connecticut Legislature


Connecticut Legislature CT Commission on Aging

Husky Healthcare




Connecticut Legislature Connecticut Voices for Children

http://www.google.com/url?sa=t&rct=j&q=medicaid%20site%3Awww.cga.ct.gov&source=web&cd=7&ved=0CIABEBYwBg&url=http%3A%2F%2Fwww.cga.ct.gov%2Fph%2Fmedicaid%2Fmmcc%2Fminutes%2Fmmc0706-att4.ppt&ei=UKbMT-6ePMm_gQezpKXHCQ&usg=AFQjCNElaYvemVyQcQtxxUma2jFKuv6eZw

http://www.cga.ct.gov/ph/medicaid/mmcc/HUSKY/HUSKYInfo.htm

Connecticut Department of Social Services

http://www.cga.ct.gov/ph/medicaid/mmcc/minutes/2012/0511/Presentation%20-%20MAPOC%20%20_5%2011%2012_Final.pdf

http://www.cga.ct.gov/coa/pdfs/Fact%20Sheets/Fact%20Sheet%20-%20duals%202-6-12.pdf


Husky Health Connecticut and Charter Oak Health Plan

http://www.cga.ct.gov/ph/medicaid/mmcc/minutes/2012/0413/Presentation%20-%20MAPOC%20-%20Enrollment%20-%204-13-12%20-%20REVFNL.pdf

Connecticut General Assembly, Public Health Committee

Senator Toni N. Harp & Representative Mary Eberle

http://www.cga.ct.gov/PH/PHCommitteeReport.htm

Connecticut Medicaid Managed Care Council, Quality Assurance Subcommittee

http://www.cga.ct.gov/ph/medicaid/mmcc/special/Forum/QAEPSDT.htm

http://www.cga.ct.gov/PH/medicaid/mmcc/minutes/2012/New%20enrollees%202010%20(MAPOC%201%2013%202012)%20(2).pdf

http://www.cga.ct.gov/PH/medicaid/mmcc/minutes/2012/h11newenrollees2010.pdf

http://www.google.com/url?sa=t&rct=j&q=medicaid%20site%3Awww.cga.ct.gov&source=web&cd=7&ved=0CIABEBYwBg&url=http%3A%2F%2Fwww.cga.ct.gov%2Fph%2Fmedicaid%2Fmmcc%2Fminutes%2Fmmc0706-att4.ppt&ei=UKbMT-6ePMm_gQezpKXHCQ&usg=AFQjCNElaYvemVyQcQtxxUma2jFKuv6eZw

http://www.cga.ct.gov/ph/medicaid/mmcc/HUSKY/HUSKYInfo.htm

http://www.cga.ct.gov/ph/medicaid/mmcc/minutes/2012/0511/Presentation%20-%20MAPOC%20%20_5%2011%2012_Final.pdf


http://www.cga.ct.gov/ph/medicaid/mmcc/minutes/2012/0413/Presentation%20-%20MAPOC%20-%20Enrollment%20-%204-13-12%20-%20REVFNL.pdf

http://www.cga.ct.gov/ph/medicaid/mmcc/special/Forum/QAEPSDT.htm


District of Columbia Department of Health Care Finance

DC Department of Health Care Finance

https://www.dc-medicaid.com/dcwebportal/nonsecure/statistics



http://dhcf.dc.gov/dhcf/cwp/view,A,1413,Q,609206,dhcfNav,%7C34822%7C.asp


https://www.dc-medicaid.com/dcwebportal/nonsecure/managedCareInfo


DC Department of Health, Medical Assistance Administration



http://dhcf.dc.gov/dhcf/cwp/view,A,1413,Q,609206,dhcfNav,%7C34822%7C.asp

https://www.dc-medicaid.com/dcwebportal/nonsecure/managedCareInfo



State of Delaware Legislature, Joint Committees, Joint Sunset Committee

http://legis.delaware.gov/Sunset/Sunset.nsf/23be96e92e414e9a85256c9300593414/f537d0cdc850808e852576800061d69e?OpenDocument&Highlight=0,Medicaid

Delaware Health and Social Services, Division of Medicaid & Medical Assistance

•State of Delaware, Division of Medicaid & Medical Assistance•Mercer

http://www.dhss.delaware.gov/dhss/dmma/reports.html

Florida Agency for Health Care Administration, Florida Medicaid

The Department of Health Services Research, Management and Policy, University of Florida

http://www.fdhc.state.fl.us/Medicaid/quality_management/mrp/contracts/med027/med027.shtml


Louis de la Parte Florida Mental Health InstituteUniversity of South Florida

http://www.fdhc.state.fl.us/Medicaid/quality_management/mrp/contracts/m0505/deliverables.shtml




http://legis.delaware.gov/Sunset/Sunset.nsf/23be96e92e414e9a85256c9300593414/f537d0cdc850808e852576800061d69e?OpenDocument&Highlight=0,Medicaid

http://www.dhss.delaware.gov/dhss/dmma/reports.html





University of Florida













Florida Agency for Health Care Administration; Florida Medicaid

http://www.fdhc.state.fl.us/Medicaid/quality_management/mrp/contracts/waivers_eval.shtml







Florida Healthy Kids https://www.healthykids.org/benefits/plans/








http://www.fdhc.state.fl.us/Medicaid/medicaid_reform/enhab_ben/previous_meetings.shtml


Maternal Child Health and Education Research and Data Center, University of Florida














Florida KidCare http://www.floridakidcare.org/resources.html


Maternal Child Health and Education Research and Data Center, University of Florida



Maternal Child Health and Education Research and Data Center, Department of Pediatrics, College of Medicine, University of Florida



Florida Center for Medicaid and the Uninsured, The University of Florida

http://www.fdhc.state.fl.us/Medicaid/quality_management/mrp/contracts/policy_research.shtml





http://www.fdhc.state.fl.us/Medicaid/quality_management/mrp/contracts/policy_research.shtml



University of Florida

Meyers and Stauffer


http://www.fdhc.state.fl.us/Medicaid/Prescribed_Drug/presentations.shtml












Georgia Department of Community Health

http://dch.georgia.gov/00/channel_title/0,2094,31446711_102898636,00.html

http://www.fdhc.state.fl.us/Medicaid/Prescribed_Drug/presentations.shtml






Meyers and Stauffer

Meyers and Stauffer

Meyers and Stauffer

Meyers and Stauffer

Meyers and Stauffer

Meyers and Stauffer



Georgia Department of Community Health, Financial Management

Metcalf Davis and Maudlin & Jenkins







http://dch.georgia.gov/00/article/0,2086,31446711_102898636_61727327,00.html




Georgia Department of Community Health, Medicaid Division


Georgia Department of Community Health, Medicaid



Georgia Department of Community Health, Medicaid

















State of Hawai'i Department of Human Services

Department of Human Services, MED-QUEST Division

http://hawaii.gov/dhs/main/reports/LegislativeReports/2006Leg










State of Hawai'i Department of Human Services, Med-Quest Division


http://www.med-quest.us/ManagedCare/consumerguides.html






















Department of Human Services



http://hawaii.gov/dhs/main/reports/LegislativeReports/2011Leg/





http://www.med-quest.us/ManagedCare/MQDquestenroll.html









http://hawaii.gov/dhs/health/medquest/


http://hawaii.gov/dhs/main/reports/AnnualReports

http://hawaii.gov/dhs/main/reports/LegislativeReports/2011Leg/

http://www.med-quest.us/ManagedCare/MQDquestenroll.html



http://hawaii.gov/dhs/health/medquest/

http://hawaii.gov/dhs/main/reports/AnnualReports


N&K CPAs, Inc.State of Hawai'i Department of Human Services

http://hawaii.gov/dhs/main/reports/fiscal


http://www.med-quest.us/ManagedCare/CmsReport.html


Department of Human Services, Department of Health


http://hawaii.gov/dhs/main/reports/fiscal

http://www.med-quest.us/ManagedCare/CmsReport.html



Iowa Legislature

Iowa Legislature Goold Health Systems

Iowa Legislature

Iowa Legislature Legislative Services Agency

https://www.legis.iowa.gov/DOCS/LSA/Docs_Filed/2012/DFJYD176.PDF

Iowa Department of Human Services

http://www.dhs.state.ia.us/Partners/Reports/PeriodicReports/Medicaid_B1/MedicaidB1History.html


http://www.dhs.state.ia.us/Partners/Reports/PeriodicReports/HawkI/HawkiAnnual.html


Medicaid Medical Directors Learning Network

http://www.ime.state.ia.us/index.html

https://www.legis.iowa.gov/DOCS/LSA/Docs_Filed/2012/DFJYD036.PDF


http://www.ime.state.ia.us/Reports_Publications/reports.html




https://www.legis.iowa.gov/DOCS/LSA/SC_MaterialsDist/2012/SDJRB047.PDF

https://www.legis.iowa.gov/DOCS/LSAReports/FiscalLunchLearn/MedicaidOverview.pdf

http://www.dhs.state.ia.us/Partners/Reports/PeriodicReports/Medicaid_B1/MedicaidB1History.html

http://www.dhs.state.ia.us/Partners/Reports/PeriodicReports/HawkI/HawkiAnnual.html

http://www.ime.state.ia.us/index.html



https://www.legis.iowa.gov/DOCS/LSA/SC_MaterialsDist/2012/SDJRB047.PDF


Iowa Legislature Legislative Services Agency

Department of Human Services

Idaho Legislature

Idaho Legislature

Idaho Legislature

https://www.legis.iowa.gov/LSAReports/medicaid.aspx

Iowa Legislature, Medicaid Elderly Waiver Program Study Committee

https://www.legis.iowa.gov/Schedules/committeeDocs.aspx?GA=82&CID=241

Office of Performance Evaluations, Idaho Legislature

http://www.legislature.idaho.gov/ope/publications/reports/r1105.pdf

Office of Performance Evaluations, Idaho Legislature

http://www.legislature.idaho.gov/ope/publications/reports/r1202f.pdf

Idaho Department of Health and Welfare


http://www.healthandwelfare.idaho.gov/Medical/Medicaid/ManagedCareforIdahoMedicaid/tabid/1931/Default.aspx

http://www.legislature.idaho.gov/budget/publications/PDFs/LBB/FY2006/Front/Medicaid.pdf


http://www.healthandwelfare.idaho.gov/Medical/Medicaid/tabid/123/Default.aspx


http://www.healthandwelfare.idaho.gov/Medical/Medicaid/LongTermCareManagedCare/tabid/1910/Default.aspx

Illinois Department of Healthcare and Family Services


http://www2.illinois.gov/hfs/ManagedCare/Pages/EQRTR.aspx


http://www2.illinois.gov/hfs/ManagedCare/Pages/Enrollment.aspx



http://www2.illinois.gov/hfs/ManagedCare/Pages/HEDISMedicaidRateChart.aspx

https://www.legis.iowa.gov/LSAReports/medicaid.aspx

http://www.legislature.idaho.gov/ope/publications/reports/r1202f.pdf

http://www.healthandwelfare.idaho.gov/Medical/Medicaid/ManagedCareforIdahoMedicaid/tabid/1931/Default.aspx

http://www.legislature.idaho.gov/budget/publications/PDFs/LBB/FY2006/Front/Medicaid.pdf

http://www.healthandwelfare.idaho.gov/Medical/Medicaid/tabid/123/Default.aspx

http://www.healthandwelfare.idaho.gov/Medical/Medicaid/LongTermCareManagedCare/tabid/1910/Default.aspx

http://www2.illinois.gov/hfs/ManagedCare/Pages/EQRTR.aspx

http://www2.illinois.gov/hfs/ManagedCare/Pages/Enrollment.aspx

http://www2.illinois.gov/hfs/ManagedCare/Pages/HEDISMedicaidRateChart.aspx


Legislative Audit Commission

Burns & Associates, Inc.

State of Illinois General Assembly www.ilga.gov/reports/special/mmctf%20final%20report.pdf

State of Illinois General Assembly www.ilga.gov/.../lac/.../Program_Audit_All_Kids_Insurance11.pdf

Indiana Family and Social Services Administration

http://www.in.gov/fssa/ompp/2545.htm

Kansas Department of Health and Environment

http://www.kdheks.gov/hcf/quality_reports/healthwave.html


http://www.kdheks.gov/hcf/medicaid_reports/Health_Care_Market_Reports.html

http://www.in.gov/fssa/ompp/2545.htm


http://www.kdheks.gov/hcf/medicaid_reports/Health_Care_Market_Reports.html


Office of the Inspector General

Kansas Health Policy Authority


http://www.kdheks.gov/hcf/oig/audit_reports.html


http://www.kdheks.gov/hcf/quality_reports/healthconnect.html




http://www.kdheks.gov/hcf/program_improvements/medicaid_healthwave.html

http://www.kdheks.gov/hcf/oig/audit_reports.html

http://www.kdheks.gov/hcf/quality_reports/healthconnect.html













http://www.kdheks.gov/hcf/medicaid_reports/default.htm




http://www.kdheks.gov/hcf/data_consortium/data_consortium_health_indicators/default.htm











http://www.kdheks.gov/hcf/data_consortium/data_consortium_health_indicators/default.htm





http://chfs.ky.gov/dms/stats.htm#Eligibility Counts

Kentucky Kids' Health


http://www.kdheks.gov/hcf/program_improvements/default.htm

Kentucky Cabinet for Health and Family Services, Department for Medicaid Services

http://chfs.ky.gov/ohp/dhppd/dataresgal.htm




Kentucky Legislative Research Commission

Kentucky Legislative Research Commission

http://www.lrc.ky.gov/lrcpubs/RR%20333_forweb.pdf



http://kidshealth.ky.gov/en/resources.htm

Louisiana Department of Health and Hospitals

http://new.dhh.louisiana.gov/index.cfm/newsroom/detail/1585





LSU Division of Economic Development: LSU Public Policy Research Lab


http://www.kdheks.gov/hcf/program_improvements/default.htm

http://chfs.ky.gov/ohp/dhppd/dataresgal.htm

http://chfs.ky.gov/dms/stats.htm#Eligibility%20Counts

http://www.lrc.ky.gov/lrcpubs/RR%20333_forweb.pdf

http://chfs.ky.gov/dms/stats.htm#Eligibility%20Counts

http://kidshealth.ky.gov/en/resources.htm





Office of the Inspector General

The Hilltop Institute


http://new.dhh.louisiana.gov/index.cfm/page/1275






Massachusetts Executive Office of Health and Human Services, Division of Health Care Finance and Policy

Division of Health Care Finance and Policy

http://www.mass.gov/eohhs/researcher/insurance/dhcfp-publications.html#annual_report

Massachusetts Executive Office of Health and Human Services, Division of Health Care Finance and Policy

http://www.mass.gov/eohhs/researcher/insurance/dhcfp-publications.html#annual_report

Massachusetts Executive Office of Health and Human Services

http://www.mass.gov/eohhs/researcher/insurance/masshealth-annual-reports.html

Office of the Inspector General Commonwealth of Massachusetts

http://www.mass.gov/ig/publications/reports-and-recommendations/2011/hlth-2011-rpt.pdf

Maryland Department of Health and Mental Hygiene


http://mmcp.dhmh.maryland.gov/SitePages/Reports%20and%20Publications.aspx





http://mmcp.dhmh.maryland.gov/healthchoice/SitePages/Consumer%20MCO%20Report%20Cards.aspx


John Hopkins Healthcare Research and Outcomes Unit

http://mmcp.dhmh.maryland.gov/docs/ED_Utilization_DHMH_052709.pdf





Maryland General Assembly

Delmarva Foundation

Delmarva Foundation







http://www.md-medicaid.org/index.htm

Maryland Department of Legislative Services

mlis.state.md.us/other/opa/Medicaid%20enrollment.pdf

MARYLAND MEDICAID PROGRAMmlis.state.md.us/other/opa/Medicaid%20program.pdf


http://mmcp.dhmh.maryland.gov/docs/2011_MD_PIPs_Cervical_Report_FINAL.pdf


http://mmcp.dhmh.maryland.gov/healthchoice/SitePages/HealthChoice%20Quality%20Assurance%20Activities.aspx

















http://www.md-medicaid.org/index.htm

http://mmcp.dhmh.maryland.gov/healthchoice/SitePages/HealthChoice%20Quality%20Assurance%20Activities.aspx






Maine State Legislature, Government Oversight Committee

Office of Program Evaluation and Government Accountability of the Maine State Legislature

www.maine.gov/.../Final%20Report%20for%20Printing%20- ...Similar

Maine State Legislature, Government Oversight Committee

Office of Program Evaluation and Government Accountability of the Maine State Legislature

www.maine.gov/legis/opega/reports/.../DME%20Final%20Report.pdfSimilar

Maine Health Data Organization's Claims Website

http://www.healthweb.maine.gov/claims/healthcost/procedure_pricing_insured.aspx

Michigan Department of Community Health, Behavioral Health and Developmental Disabilities Administration


http://www.michigan.gov/mdch/0,4612,7-132-2941_4868_4902---,00.html

Michigan Department of Community Health, Behavioral Health and Developmental Disabilities Administration


http://www.michigan.gov/mdch/0,4612,7-132-2941_4868_4902-231128--,00.html

Michigan Department of Community Health


http://www.michigan.gov/mdch/0,4612,7-132-2943_4860-130530--,00.html



http://www.michigan.gov/documents/QualityCheckupJan03_59423_7.pdf

Michigan Department of Community Health, Office of Audit


http://www.michigan.gov/documents/MDCH_Medicaid_Home_Help_Program_Report_171843_7.pdf






http://www.michigan.gov/documents/mdch/MDCH_Follow-up_Audit_of_the_MI_Choice_Home_and_Community_Based_Services_Waiver_for_the__Elderly_and__Disabled_176182_7.pdf

https://www.google.com/search?hl=en&rls=com.microsoft:en-us&q=related:www.maine.gov/legis/opega/GOC/GOC_meetings/Current_handouts/2-27-09/Final%20Report%20for%20Printing%20-%20Amended%20for%20KidsPeace.pdf&tbo=1&sa=X&ei=p9qWT5m8LKLk6QH02KHGDg&ved=0CCcQHzABOAo

https://www.google.com/search?hl=en&rls=com.microsoft:en-us&q=related:www.maine.gov/legis/opega/reports/DME/DME%20Final%20Report.pdf&tbo=1&sa=X&ei=g9iWT-27IKq36QGX7KimDg&ved=0CC8QHzAC

http://www.healthweb.maine.gov/claims/healthcost/procedure_pricing_insured.aspx

http://www.michigan.gov/mdch/0,4612,7-132-2941_4868_4902-231128--,00.html



http://www.michigan.gov/documents/mdch/MDCH_Follow-up_Audit_of_the_MI_Choice_Home_and_Community_Based_Services_Waiver_for_the__Elderly_and__Disabled_176182_7.pdf











Minnesota Department of Human Services, Health Care Administration

•Minnesota Department of Human Services, Performance Measurement and Quality Improvement Division

•Minnesota Department of Health and Minnesota Department of Human Services

http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_010105

Minnesota Department of Human Services


http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_006303#


Minnesota Department of Human Services, Performance Measurement and Quality Improvement Division







Minnesota State Legislature Burns and Associates, Inc.

Minnesota State Legislature The Myers Group www.leg.state.mn.us/docs/2006/Other/060029.pdf

Minnesota State Legislature www.leg.state.mn.us/docs/2010/other/100752.pdf


Minnesota Department Human Services, Performance Measurement and Quality Improvement Division




http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_137160


Minnesota Department of Human Services, Reports and Forecasts Divisions

http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=health_care

http://archive.leg.state.mn.us/docs/2010/other/100321.pdf


MN Community Measurement and Minnesota Department of Human Services



Ryan Johnson, Kate Kingery, Debbie Markery, Pat Redder





Research Department, Minnesota House of Representatives










Minnesota Department Human Services, Performance Measurement and Quality Improvement Division






Minnesota Department of Human Services Performance Measurement and Quality Improvement, Health Care Research and Evaluation Division





Center for Social and Behavioral Research,University of Northern Iowa



Minnesota Department of Health and Minnesota Department of Human Services









StratisHealth





Minnesota Department of Human Services Performance Measurement and Quality Improvement



StratisHealth, SHADAC, The Urban Coalition, and Community Researchers




MInnesota Department of Human Services, Research and Policy



Minnesota Health Data Institute

Wilder Research Center

MInnesota Department of Human Services, Research and Policy


Minnesota Department of Human Services, Research and Policy



Malone Consulting, Paone and Associates, Carle Foundation Health Systems Research Center



Minnesota Health Data Institute

http://www.dss.mo.gov/re/fsdar.htm

http://www.dss.mo.gov/re/fsd_mhdmr.htm

The Lewin Group



Missouri Department of Social Services, MO HealthNet Division

Alicia Smith and Associates, LLC

http://www.dss.mo.gov/mhd/oversight/resources.htm


Missouri Department of Social Services




Mercer, Marsh, Kroll, Guy Carpenter, Oliver Wyman






The Lewin Group

The Lewin Group

The Lewin Group

The Lewin Group

http://www.dss.mo.gov/mis/qfact.htm

http://www.dss.mo.gov/rr_stats.htm

Mississippi Division of Medicaid

Mississippi Division of Medicaid http://www.medicaid.ms.gov/AnnualReports.aspx


http://leg.mt.gov/css/fiscal/past-charts.asp

Montana Legislature Lois Steinbeck














http://www.medicaid.ms.gov/Documents/FY09GenericPresentation.pdf

Mississippi Division of MedicaidMississippi Division of Medicaid

http://www.medicaid.ms.gov/Documents/TotalDeliveries.pdf

Montana Department of Public Health and Human Services

http://www.dphhs.mt.gov/statisticalinformation/index.shtml

Montana Legislature, Legislative Fiscal Division

http://leg.mt.gov/css/fiscal/reports/2009-2010-interim-reports.asp


http://www.dphhs.mt.gov/statisticalinformation/tanfstats/tanfstatistics.shtml

http://www.medicaid.ms.gov/Documents/TotalDeliveries.pdf


The Legislative Fiscal Division

Montana Legislature Thompson Reuters

http://www.ncdhhs.gov/dma/pub/index.htm

http://www.ncdhhs.gov/dma/legis/index.htm

http://www.ncdhhs.gov/dma/elig/index.htm

North Carolina General Assembly

Montana Legislature, Legislative Fiscal Division

http://leg.mt.gov/css/fiscal/reports/Health-Care-Publications.asp

Montana Legislature, Efficiency in Government Committee

http://leg.mt.gov/css/committees/interim/2011-2012/Efficiency-in-Government/Topic-Areas/Medicaid/medicaid.asp

http://leg.mt.gov/css/fiscal/reports/2009-2010-interim-reports.asp


http://medicaidprovider.hhs.mt.gov/providerpages/info.shtml

North Carolina Department of Health and Human Services, Division of Medical Assistance


State of North Carolina Department of Health and Human Services, Division of Medical Assistance


Blue Ribbon Commission on Medicaid Reform

http://www.ncga.state.nc.us/library/Collections/studies/insurance.html



http://www.ncdhhs.gov/dma/pub/index.htmhttp://www.ncdhhs.gov/dma/legis/index.htm







Program Evaluation Division North Carolina General Assembly

http://www.ncga.state.nc.us/PED/Reports/Topics/Health.html


http://www.ncdhhs.gov/dma/countyreports/index.htm





http://www.ncdhhs.gov/dma/quality/index.htm



Division of Medical Assistance http://www.ncdhhs.gov/dma/pub/annualreports.htm




Program Evaluation Division North Carolina General Assembly

http://www.ncga.state.nc.us/PED/Reports/Topics/Health.html


http://www.ncdhhs.gov/dma/healthcheck/participationdata.htm


North Carolina Health and Human Services






Navigant Consulting


Fiscal Research Division, North Carolina General Assembly

www.ncga.state.nc.us/.../frd.../2009%20Medicaid%20Overview.pdf




Blue Cross and BlueShield of North Carolina

http://www.ncdhhs.gov/dma/chip/chipannreport.htm


http://www.ncdhhs.gov/dma/services/familyplanning.htm













North Carolina Department of Health and Human Services, The Quality, Evaluation and Health Outcomes Unit

North Carolina Health and Human Services, Division of Medical Assistance

http://www.ncdhhs.gov/dma/quality/QAStrategyForPHC.pdf







Center for Children's Healthcare Improvement, Department of Pediatrics, University of North Carolina at Chapel Hill



North Dakota Legislative Branch



http://www.nd.gov/dhs/info/pubs/about.html

http://www.nd.gov/dhs/info/pubs/about.html




North Dakota Department of Human Services

•http://www.nd.gov/dhs/services/medicalserv/medicaid/covered.html•http://www.nd.gov/dhs/services/adultsaging/homecare3.html•http://www.nd.gov/dhs/services/medicalserv/medicaid/docs/medicaid-waiver-services.pdf



http://www.nd.gov/dhs/info/testimony/2005-2006-interim/budget-human-services/20060913-biennial-medicaid-rpt.pdf

www.legis.nd.gov/fiscal/biennium-reports/61.../humanservices.pdf

www.legis.nd.gov/assembly/61-2009/docs/.../bs120810appendixl.pdf

North Dakota Legislative Council Staff

www.legis.nd.gov/assembly/60-2007/docs/pdf/99285.pdf


http://www.nd.gov/dhs/info/pubs/docs/medical-recipientsurvey-results-detailed2004.pdf

North Dakota Department of Human ServicesNorth Dakota Department of Human Services


Maggie Anderson, Director of the Medical Services Division

www.legis.nd.gov/assembly/61-2009/docs/.../hh032310appendixo.p...

Curtis Volesky, Director of Medicaid Eligibility

www.legis.nd.gov/assembly/61-2009/docs/.../ib020410appendixl.pdf

http://www.legis.nd.gov/assembly/60-2007/docs/pdf/99285.pdf

http://www.nd.gov/dhs/info/pubs/docs/medical-recipientsurvey-results-detailed2004.pdf


Nebraska Legislature

Nebraska Legislature

Nebraska Department of Health and Human Services

http://dhhs.ne.gov/medicaid/Pages/med_reform_expenditures.aspx#Charts

nebraskalegislature.gov/pdf/reports/.../select.../cbho_2011_lb603.pdf


http://dhhs.ne.gov/medicaid/Pages/med_reform_reports.aspx


http://dhhs.ne.gov/medicaid/Pages/med_reform_growth.aspx


http://dhhs.ne.gov/medicaid/Pages/med_reform_growth.aspx

Performance Audit Section, Legislative Research Division, Nebraska Legislature

nebraskalegislature.gov/pdf/reports/.../progaudit_0505_medicaid.pdf

New Hampshire Department of Health and Human Services, Office of Medicaid Business and Policy

•Primary Care Services- Cutler Institute for Health and Social Policy, University of Southern Maine•All other reports- Maine Health Information Center

http://www.dhhs.nh.gov/ombp/publications.htm





New Jersey Legislature






NJFamilyCare


•2009- Onpoint Health Data •2008 and 2007- Maine Health Information Center

http://www.dhhs.nh.gov/ombp/documents/chip09.pdf


New Hampshire Department of Health and Human Services


Office of Medicaid Business and Policy, New Hampshire Department of Health and Human Services

New Jersey State Legislature Office of Legislative Services Office of the State Auditor

http://www.njleg.state.nj.us/legislativepub/auditreports_department.asp#HHS








www.njleg.state.nj.us/legislativepub/auditor/54577.pdf



http://www.njfamilycare.org/enroll/enroll_chart.html




http://www.hsd.state.nm.us/mad/EqroReports.html


Department of Human Services, Division of Medical Assistance and Health Services


http://www.state.nj.us/humanservices/dmahs/news/


http://www.state.nj.us/humanservices/dmahs/news/reports/index.html


Outreach, Enrollment, and Retention Working Group

http://www.state.nj.us/humanservices/dmahs/news/njfc_work_group.html



New Mexico Human Services Department, Medical Assistance Division

New Mexico Medical Review Association



http://www.state.nj.us/humanservices/dmahs/news/


New Mexico Legislature Department of Human Services


The Hilltop Institute http://www.hsd.state.nm.us/mad/ChildAdult.html


•www.nmlegis.gov/.../DISC%20100711%20Coordination%20of%20L…•http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=38&ved=0CFYQFjAHOB4&url=http%3A%2F%2Fwww.nmlegis.gov%2Flcs%2Fhandouts%2FDISC%2520100711%25201915%2520B%2520CoLTS%2520Managed%2520Care%2520Cost%2520Effectiveness%2520Overview%2520Fact%2520Sheet%25202.PDF&ei=tu28T9zrHInAgQfBtbm7Dw&usg=AFQjCNEEoSm_4B8M6j6CiN-t_nEsp24a7A•http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=51&ved=0CFQQFjAAODI&url=http%3A%2F%2Fwww.nmlegis.gov%2Flcs%2Fhandouts%2FDISC%2520100711%2520Status%2520of%2520Cordination%2520of%2520Long-Term%2520Services%2520Program.PDF&ei=ovi8T5-sIcvhggei0dC7Dw&usg=AFQjCNFHT9DJIFuwkw4mfe0NMPdH5UJnzg







New Mexico Legislature


The Myers Group http://www.hsd.state.nm.us/mad/CSSurveys.html



New Mexico Human Services Department

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=31&ved=0CEgQFjAAOB4&url=http%3A%2F%2Fwww.nmlegis.gov%2Flcs%2Fhandouts%2FHSD%2520Breast%2520and%2520Cervical%2520Cancer%2520Program.pdf&ei=tu28T9zrHInAgQfBtbm7Dw&usg=AFQjCNGPAE0829fOjglYF-eMUIEY0bGT7w





http://www.hsd.state.nm.us/mad/RMedicaidEligibility.html



http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=6&ved=0CHAQFjAF&url=http%3A%2F%2Fwww.nmlegis.gov%2Flcs%2Fhandouts%2FFY10%2520Medicaid%2520Spending%2C%2520etc..pdf&ei=vi61T6n7MPSA6QGaotH4Dw&usg=AFQjCNHVXMkeZUpabqYDozZaDypsFep9bw


http://www.hsd.state.nm.us/mad/HedisReports.html












IPRO http://www.hsd.state.nm.us/mad/EqroReports.html










http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=32&ved=0CEoQFjABOB4&url=http%3A%2F%2Fwww.nmlegis.gov%2Flcs%2Fhandouts%2FDISC%2520100711%2520Personal%2520Care%2520Option%2520Program%2520Update.PDF&ei=tu28T9zrHInAgQfBtbm7Dw&usg=AFQjCNH71kZ9EuXvGq8Xt4TEecDG82jwQg







Human Services Department and Office of the Attorney General Medicaid Fraud, Waste, and Abuse Controls

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=34&ved=0CE4QFjADOB4&url=http%3A%2F%2Fwww.nmlegis.gov%2Flcs%2Flfc%2Flfcdocs%2Fperfaudit%2FWaste%2C%2520Fraud%2520in%2520Medicaid%2520Program%2520Evaluation%2520Report.pdf&ei=tu28T9zrHInAgQfBtbm7Dw&usg=AFQjCNHuBMxtV8FCCwCo-j0vqS5_CfksDQ



https://dhcfp.nv.gov/Waivers/Wcaseloads.htm

https://dhcfp.nv.gov/Pharmacy.htm



Nevada Department of Health and Human Services, Division of Health Care Financing and Policy


https://dhcfp.nv.gov/BehavioralHealth/BH_OOS.htm


First Health Services Corporation

Nevada Department of Health and Human Services, Division of Welfare and Supportive Services

https://dwss.nv.gov/index.php?option=com_content&task=view&id=27&Itemid=64


https://nevadacheckup.nv.gov/enrollmentstats.asp


First Health Services Corporation

https://dhcfp.nv.gov/BehavioralHealth/BH_Reports.htm

https://nevadacheckup.nv.gov/enrollmentstats.asp


https://dhcfp.nv.gov/FactSheets.htm

Magellan

Nevada Legislature

IPRO


Division of Health Care Financing and Policy


https://dhcfp.nv.gov/BehavioralHealth/BH_Reports.htm


www.leg.state.nv.us/74th/Interim_Agendas.../E103107E.pdf



https://dhcfp.nv.gov/managed.htm

New York State, Department of Health

New York State Department of Health Division of Quality and Evaluation, Office of Health Insurance Programs

http://www.health.ny.gov/health_care/managed_care/reports/


New York State Department of Health

http://www.health.ny.gov/statistics/health_care/managed_care/plans/reports/docs/all_plan_summary.pdf




http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link2

https://dhcfp.nv.gov/managed.htm

http://www.health.ny.gov/statistics/health_care/managed_care/plans/reports/docs/all_plan_summary.pdf





The Lewin Group in Collaboration with the AIDS Institute, New York State Department of Health

http://www.health.ny.gov/health_care/managed_care/living_with_hiv/index.htm


New York Department of Health Office of Health Insurance Program

http://www.health.ny.gov/statistics/health_care/managed_care/plans/reports/#hiv_snp_reports





New York State Department of Health Bureau of Quality Measurement and Improvement

http://www.health.ny.gov/health_care/managed_care/qarrfull/qarr_2011/supplement_intro.htm

http://www.health.ny.gov/statistics/health_care/managed_care/plans/reports/#hiv_snp_reports


IPRO


New York State Department of Health

http://www.health.ny.gov/health_care/managed_care/report/q_report.htm


http://www.health.ny.gov/health_care/managed_care/consumer_guides/


http://www.health.ny.gov/health_care/managed_care/mltc/


Data Management Unit of the Fiscal Management Group in New York State Dept of Health

http://www.health.ny.gov/statistics/health_care/medicaid/eligible_expenditures/


Data Management Unit of the Fiscal Management Group in New York State Dept of Health





Data Management Unit of the Fiscal Management Group in NY State Dept of Health

http://www.health.ny.gov/statistics/health_care/medicaid/quarterly/aid/


http://www.health.ny.gov/health_care/managed_care/reports/enrollment/monthly/



http://www.health.ny.gov/statistics/health_care/medicaid/quarterly/aid/


IPRO


















http://www.jfs.ohio.gov/OHP/mbiwd.stm




Ohio Department of Job and Family Services




http://www.jfs.ohio.gov/OHP/bmhc/con-man-care-reports.stm


http://www.jfs.ohio.gov/OHP/reports/data/NewMedicaidDataLinkPage.stm




http://www.jfs.ohio.gov/OHP/reports/data/MedicaidDataReports.stm


Ohio Department of Job and Family Services, Bureau of Long-Term Care Services and Supports

http://www.jfs.ohio.gov/OHP/consumers/HCBS.stm




Ohio Department of Job and Family Services, Bureau of Community Services Policy

http://www.jfs.ohio.gov/OHP/consumers/docs/IO%20Report_FINAL_PDF.pdf











Ohio Department of Job and Family Services, Bureau of Long-Term Care Services and Supports

http://www.jfs.ohio.gov/OHP/reports/Trans%20DD%20and%20OHP%20Ongoing%20Review%20Report.pdf


http://www.jfs.ohio.gov/OHP/reports/ohMedRpts.stm




http://www.jfs.ohio.gov/OHP/reports/Trans%20DD%20and%20OHP%20Ongoing%20Review%20Report.pdf


Oklahoma Health Care Authority


Oklahoma Health Care Authority APS Healthcare




Oklahoma Health Care Authority APS Healthcare


Oklahoma Health Care Authority Mathematica Policy Research



http://www.okhca.org/research.aspx?id=87&parts=7447


































Oregon Health Plan

Oregon Health Plan Westat and Shaller Consulting














•Actuarial Service Unit,Budget Planning and Analysis, Department of Human Services, State of Oregon•PricewaterhouseCoopers

http://www.oregon.gov/OHA/healthplan/data_pubs/rates-costs/main.shtml#caprate

http://www.oregon.gov/OHA/healthplan/data_pubs/main.shtml








http://www.oregon.gov/OHA/healthplan/data_pubs/rates-costs/main.shtml#caprate



Oregon Health Plan

Oregon Health Plan

Oregon Health Plan

Oregon Health Plan

Department of Human Services, Division of Medical Assistance Programs


Division of Medical Assistance Programs, Data Informatics Unit

http://www.oregon.gov/OHA/healthplan/data_pubs/demog/main.shtml

State of Oregon, Division of Medical Assistance Programs

http://www.oregon.gov/OHA/healthplan/data_pubs/eligibles/main.shtml

State of Oregon, Division of Medical Assistance Programs

http://www.oregon.gov/OHA/healthplan/data_pubs/enrollment/main.shtml

Pennsylvania Department of Public Welfare

•Office of Medical Assistance Programs, Division of Quality and Special Needs Coordination, Pennsylvania Department of Public Welfare•Not applicable•Pennsylvania Department of Public Welfare

http://www.dpw.state.pa.us/publications/healthchoicespublications/index.htm






Pennsylvania's Children's Health Insurance Program

http://www.chipcoverspakids.com/about-chip/enrollment-figures/



http://listserv.dpw.state.pa.us/ma-food-stamps-and-cash-stats.html


http://www.oregon.gov/OHA/healthplan/data_pubs/demog/main.shtml

http://www.oregon.gov/OHA/healthplan/data_pubs/eligibles/main.shtml

http://www.oregon.gov/OHA/healthplan/data_pubs/enrollment/main.shtml




http://www.chipcoverspakids.com/about-chip/enrollment-figures/

http://listserv.dpw.state.pa.us/ma-food-stamps-and-cash-stats.html




http://www.dpw.state.pa.us/publications/statisticalreports/index.htm



MCH Evaluation, Inc.




Rhode Island Department of Human Services

http://www.dhs.ri.gov/Publications/ReportsPublications/MedicalAssistanceProgramMedicaid/tabid/757/Default.aspx











Center for Child and Family Health, Department of Human Services, State of Rhode Island and Providence Plantations

http://www.dhs.ri.gov/ReportsPublications/ReportsPublications/RIteCareRIteShare/tabid/750/Default.aspx


http://www.dhs.ri.gov/ReportsPublications/ReportsPublications/LongTermCare/tabid/1006/Default.aspx






Center for Gerontology and Health Care Research, Brown University



Center for Gerontology and Health Care Research, Brown University



Rhode Island Executive Office of Health and Human Services

http://www.dhs.ri.gov/ReportsPublications/ReportsPublications/MedicaidGlobalWaiver/tabid/994/Default.aspx







Executive Office of Health and Human Services



Executive Office of Health and Human Services

http://www.dhs.ri.gov/Publications/ReportsPublications/AnnualReports/tabid/148/Default.aspx



http://www.dhs.ri.gov/ReportsPublications/ReportsPublications/MedicaidGlobalWaiver/tabid/994/Default.aspx




http://www.dhs.ri.gov/Publications/ReportsPublications/AnnualReports/tabid/148/Default.aspx


MAXIMUS

South Carolina Legislature

State of Rhode Island General Assembly

State of Rhode Island, Senate Fiscal Office

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CGcQFjAA&url=http%3A%2F%2Fwww.rilin.state.ri.us%2FSenateFinance%2Fissue_briefs%2FIB6%2520-%2520RIte%2520Care%2520and%2520RIte%2520Share.pdf&ei=jBKtT-urE-ae6QGC0vn3DA&usg=AFQjCNHn5eA9ThSEY9Cev0QyQ5DSa3GpRg&sig2=ir6N0JrweoDxESf0TUpaYQ





RI Medicaid Research and Evaluation Project



New England States Consortium Systems Organization (NESCSO)


South Carolina Department of Health and Human Services

http://msp.scdhhs.gov/managedcare/?page_id=66


Madalena/Tester, Milliman, University of South Carolina's Institute for Families in Society

http://msp.scdhhs.gov/msp/wp-content/uploads/2010/09/Medicaid-Cost-and-Quality-Effectiveness.pdf

South Carolina Health and Human Services

Madalena/Tester, Milliman, University of South Carolina's Institute for Families in Society

http://msp.scdhhs.gov/msp/wp-content/uploads/2010/09/Medicaid-Cost-and-Quality-Effectiveness.pdf


www.scstatehouse.gov/.../FraudReportForProviso21.37April12012.p



http://msp.scdhhs.gov/managedcare/?page_id=66


South Carolina Legislature

Aon Hewitt

Qsource

Bureau of TennCare

Bureau of TennCare


Report of the Medicaid Transportation Advisory Committee

South Dakota Department of Social Services

http://dss.sd.gov/statistics/monthly.asp


http://dss.sd.gov/medicalservices/stats/index.asp


http://dss.sd.gov/medicaid_solutions_rfi.asp

Tennessee Government, Bureau of TennCare

http://www.tn.gov/tenncare/news-reports.html#1


http://www.tn.gov/tenncare/news.html


http://www.tn.gov/tenncare/pro-hedis.html




http://www.tn.gov/tenncare/news-reports.shtml#2



The University of Tennessee, Knoxville

The University of Tennessee Center for Business and Economic Research

http://cber.bus.utk.edu/tncare.htm


Department of Finance and Administration, Bureau of TennCare


http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=5&ved=0CEEQFjAE&url=http%3A%2F%2Fwww.scstatehouse.gov%2Freports%2Fdhhs%2FReportOfTheMedicaidTransportationAdvisoryCommittee12-2.pdf&ei=FiGXT8bkIsf46QG4pK2WDg&usg=AFQjCNGAznHr4IJH4_dV1P_rUi

http://dss.sd.gov/statistics/monthly.asp

http://dss.sd.gov/medicalservices/stats/index.asp

http://dss.sd.gov/medicaid_solutions_rfi.asp


http://www.tn.gov/tenncare/news.html

http://www.tn.gov/tenncare/pro-hedis.html


http://www.tn.gov/tenncare/news-reports.shtml#2


http://cber.bus.utk.edu/tncare.htm



Texas Health and Human Services Commission

http://www.hhsc.state.tx.us/research/index.shtml


The Institute for Child Health PolicyUniversity of Florida

http://www.hhsc.state.tx.us/medicaid/mc/reports.html


http://www.hhsc.state.tx.us/medicaid/med_providers.html


http://www.hhsc.state.tx.us/research/timeliness.shtml



http://www.hhsc.state.tx.us/medicaid/mc/about/reports/confirmed_eligibles_report.html


The Institute for Child Health PolicyUniversity of Florida




http://www.hhsc.state.tx.us/medicaid/other.asp


http://www.hhsc.state.tx.us/medicaid/reports/PB8/PinkBookTOC.html


The Institute for Child Health Policy, University of Florida





http://www.hhsc.state.tx.us/research/index.shtml


http://www.hhsc.state.tx.us/medicaid/med_providers.html

http://www.hhsc.state.tx.us/research/timeliness.shtml

http://www.hhsc.state.tx.us/medicaid/mc/about/reports/confirmed_eligibles_report.html



http://www.hhsc.state.tx.us/medicaid/reports/PB8/PinkBookTOC.html




Utah Department of Health


Utah Department of Health Utah Department of Health


Utah State Legislature










https://health.utah.gov/myhealthcare/reports/hedis/index.php?&mytabsmenu=0

https://health.utah.gov/myhealthcare/reports/cahps/2011/?page=home

http://health.utah.gov/medicaid/stplan/legisrept.htm

Bureau of Financial Services, Division of Medicaid and Health Financing, Utah Department of Health

http://www.health.state.ut.us/medicaid/pdfs/annual_report2011.pdf

Office of the Legislative Fiscal Analyst

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=3&ved=0CF4QFjAC&url=http%3A%2F%2Fwww.le.utah.gov%2Flfa%2Freports%2FBBIB%2FAPPSOC_2-7-12_12.pdf&ei=THGtT6HfJ6bg0QGK1dypDA&usg=AFQjCNHpWtrA0lxcexzJQ7Z-GrTG4S6c6Q




https://health.utah.gov/myhealthcare/reports/hedis/index.php?&mytabsmenu=0

https://health.utah.gov/myhealthcare/reports/cahps/2011/?page=home

http://health.utah.gov/medicaid/stplan/legisrept.htm

http://www.health.state.ut.us/medicaid/pdfs/annual_report2011.pdf

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=3&ved=0CF4QFjAC&url=http%3A%2F%2Fwww.le.utah.gov%2Flfa%2Freports%2FBBIB%2FAPPSOC_2-7-12_12.pdf&ei=THGtT6HfJ6bg0QGK1dypDA&usg=AFQjCNHpWtrA0lxcexzJQ7Z-GrTG4S6c6Q


Utah Department of Health Utah Department of Health

Utah State Legislature

WB&A Market Research

WB&A Market Research

http://ibis.health.utah.gov/publications orhttp://health.utah.gov/opha/publications/hsu/1201_MedServe.pdf

Office of the Legislative Fiscal Analyst

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=5&ved=0CGEQFjAE&url=http%3A%2F%2Fwww.le.utah.gov%2Flfa%2Freports%2FBBIB%2FAPPSOC_2-2-12_12.pdf&ei=THGtT6HfJ6bg0QGK1dypDA&usg=AFQjCNEsns4leALk-aBPzkqP9u-TECovJA

Virginia Department of Medical Assistance Services

•http://dmasva.dmas.virginia.gov/Content_pgs/mc-home.aspx•Specific report: http://dmasva.dmas.virginia.gov/Content_atchs/mc/cahps-f1.pdf


•http://dmasva.dmas.virginia.gov/Content_pgs/mc-home.aspx•Specific report: http://dmasva.dmas.virginia.gov/Content_atchs/mc/cahps-f2.pdf


Delmarva Foundation for Medical Care

•http://dmasva.dmas.virginia.gov/Content_pgs/mc-home.aspx•Specific report: http://dmasva.dmas.virginia.gov/Content_atchs/mc/apr-f5.pdf



•http://dmasva.dmas.virginia.gov/Content_pgs/mc-home.aspx•Specific report: http://dmasva.dmas.virginia.gov/Content_atchs/mc/fs-f2.pdf



•http://dmasva.dmas.virginia.gov/Content_pgs/mc-home.aspx•Specific report: http://dmasva.dmas.virginia.gov/Content_atchs/mc/fs-f1.pdf


Department of Medical Assistance Services

•http://dmasva.dmas.virginia.gov/Content_pgs/mc-home.aspx•Specific report: http://dmasva.dmas.virginia.gov/Content_atchs/mc/apr-f6.pdf

http://ibis.health.utah.gov/publications

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=5&ved=0CGEQFjAE&url=http%3A%2F%2Fwww.le.utah.gov%2Flfa%2Freports%2FBBIB%2FAPPSOC_2-2-12_12.pdf&ei=THGtT6HfJ6bg0QGK1dypDA&usg=AFQjCNEsns4leALk-aBPzkqP9u-TECovJA


Acumentra Health

Acumentra Health


Department of Medical Assistance Services

http://dmasva.dmas.virginia.gov/Content_pgs/ltc-wvr.aspx


http://dmasva.dmas.virginia.gov/default.aspx

Department of Vermont Health Access, Agency of Human Services


http://dvha.vermont.gov/budget-legislative



http://dvha.vermont.gov/budget-legislative/green-mountain-care-enrollment-reports

Washington State Department of Social and Health Services, Washington State Health Care Authority

http://hrsa.dshs.wa.gov/healthyoptions/newho/reports/reports.htm




Department of Social and Health Services



Department of Social and Health Services

http://hrsa.dshs.wa.gov/healthyoptions/NewHO/Reports/CCM.htm


http://hrsa.dshs.wa.gov/news/enrollmentfigures.htm


Department of Social and Health Services, Health and Recovery Services Administration

http://hrsa.dshs.wa.gov/News/Brief4Leg.htm

http://dmasva.dmas.virginia.gov/Content_pgs/ltc-wvr.aspx

http://dmasva.dmas.virginia.gov/default.aspx

http://dvha.vermont.gov/budget-legislative

http://dvha.vermont.gov/budget-legislative/green-mountain-care-enrollment-reports




http://hrsa.dshs.wa.gov/healthyoptions/NewHO/Reports/CCM.htm

http://hrsa.dshs.wa.gov/news/enrollmentfigures.htm

http://hrsa.dshs.wa.gov/News/Brief4Leg.htm


APS Healthcare

Wisconsin State Legislature Legislative Audit Bureau

Wisconsin State Legislature Legislative Audit Bureau

ForwardHealth (Wisconsin's Medicaid)

https://www.forwardhealth.wi.gov/WIPortal/portals/0/staticContent/Member/caseloads/481-caseload.htm


https://www.forwardhealth.wi.gov/WIPortal/Tab/42/icscontent/Managed%20Care%20Organization/reports_data/monthlyreports/index.htm.spage


https://www.forwardhealth.wi.gov/WIPortal/Tab/42/icscontent/Member/caseloads/enrollment/enrollment.htm.spage


https://www.forwardhealth.wi.gov/WIPortal/Tab/42/icscontent/Managed%20Care%20Organization/archives.htm.spage


https://www.forwardhealth.wi.gov/WIPortal/Tab/42/icscontent/Managed%20Care%20Organization/reports_data/reportsData.htm.spage


Wisconsin Department of Health ServicesDivision of Health Care Access and Accountability


http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=2&ved=0CE8QFjAB&url=http%3A%2F%2Flegis.wisconsin.gov%2Flab%2Freports%2F11-15full.pdf&ei=UHetT8GULKng0QHd-d2SDA&usg=AFQjCNHef0HRqfZxO6DHWQUmC42dnNKOyA

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CE4QFjAA&url=http%3A%2F%2Flegis.wisconsin.gov%2Flab%2Freports%2F11-badgercareplus_ltr.pdf&ei=wHutT6yzA_Lr0QHnzeGsDA&usg=AFQjCNHA-nZLOHObGqVtKEsCHtCX8weLfQ

West Virginia Children's Health Insurance Program

http://www.chip.wv.gov/enrollment_info/Pages/default.aspx

West Virginia Department of Health and Human Services

http://www.wvdhhr.org/oamr/reports.html


http://www.dhhr.wv.gov/bms/mco/Pages/ManagedCareMonthlyEnrollment.aspx


Department of Health and Human Services

http://www.dhhr.wv.gov/bms/AboutUs/lir/Pages/default.aspx


http://www.dhhr.wv.gov/bms/ehr/Pages/default.aspx


http://www.dhhr.wv.gov/bms/cp/Pages/default.aspx

https://www.forwardhealth.wi.gov/WIPortal/portals/0/staticContent/Member/caseloads/481-caseload.htm

https://www.forwardhealth.wi.gov/WIPortal/Tab/42/icscontent/Managed%20Care%20Organization/reports_data/monthlyreports/index.htm.spage

https://www.forwardhealth.wi.gov/WIPortal/Tab/42/icscontent/Member/caseloads/enrollment/enrollment.htm.spage

https://www.forwardhealth.wi.gov/WIPortal/Tab/42/icscontent/Managed%20Care%20Organization/archives.htm.spage



http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=2&ved=0CE8QFjAB&url=http%3A%2F%2Flegis.wisconsin.gov%2Flab%2Freports%2F11-15full.pdf&ei=UHetT8GULKng0QHd-d2SDA&usg=AFQjCNHef0HRqfZxO6DHWQUmC42dnNKOyA

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CE4QFjAA&url=http%3A%2F%2Flegis.wisconsin.gov%2Flab%2Freports%2F11-badgercareplus_ltr.pdf&ei=wHutT6yzA_Lr0QHnzeGsDA&usg=AFQjCNHA-nZLOHObGqVtKEsCHtCX8weLfQ

http://www.chip.wv.gov/enrollment_info/Pages/default.aspx

http://www.wvdhhr.org/oamr/reports.html

http://www.dhhr.wv.gov/bms/mco/Pages/ManagedCareMonthlyEnrollment.aspx

http://www.dhhr.wv.gov/bms/AboutUs/lir/Pages/default.aspx

http://www.dhhr.wv.gov/bms/ehr/Pages/default.aspx

http://www.dhhr.wv.gov/bms/cp/Pages/default.aspx


Wyoming Department of Health

Wyoming Department of Health

State of Wyoming Legislature

Wyoming Department of Health, Division of Healthcare Financing


•http://health.wyo.gov/healthcarefin/equalitycare/index.html•Specific report: http://health.wyo.gov/Media.aspx?mediaId=12032


•http://health.wyo.gov/healthcarefin/equalitycare/index.html•Specific report: http://health.wyo.gov/Media.aspx?mediaId=11322


•http://health.wyo.gov/healthcarefin/equalitycare/index.html•http://health.wyo.gov/Media.aspx?mediaId=7203


http://www.health.wyo.gov/healthcarefin/chip/index.html

Wyoming Legislative Service Office, Management Audit Committee

http://legisweb.state.wy.us/progeval/REPORTS/2007/chip/chip.pdf

http://www.health.wyo.gov/healthcarefin/chip/index.html