Managed Care Archive

results in Managed Care.
  • Florida Maternal and Child Health Fact Sheet

    This fact sheet reports data from several sources that measure Medicaid managed care health care delivery and quality pertaining to maternal and child health. They highlight and summarize information from the state's External Quality Review Report, measures from the Healthcare Effectiveness Data and Information Set (HEDIS), results from the…

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  • Ohio Maternal and Child Health Fact Sheet

    This fact sheet reports data from several sources that measure Medicaid managed care health care delivery and quality pertaining to maternal and child health. They highlight and summarize information from the state's External Quality Review Report, measures from the Healthcare Effectiveness Data and Information Set (HEDIS), results from the…

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  • Finding and Analyzing Medicaid Quality Measures

    This brief provides tools to find the major sources of state and plan-level Medicaid quality data, to learn how to evaluate and compare results, and to use those skills to improve data transparency and to push your state to hold plans accountable to their mission: to manage care effectively…

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  • NHeLP Comments on HHS Regulations Rule (aka SUNSET Rule)

    In the Regulations Rule, HHS seeks to retroactively impose a mandatory expiration date on an estimated 18,000 duly promulgated regulations. Even long-standing rules would be automatically rescinded unless they survive a complex process of assessment and review. Programs like Medicaid and the Children's Health Insurance Program (CHIP) could be…

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  • California Policy Needs During COVID and Beyond: Due Process

    Medi-Cal is a lifeline for Californians during the COVID-19 public health emergency (PHE). Among the many crucial benefits of Medi-Cal, beneficiaries have strong due process protections including the right to written notices, an appeal of denials, and a hearing. These protections ensure that beneficiaries have meaningful rights to challenge…

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  • Medicaid External Quality Review: An Updated Overview

    In 2016, the Centers for Medicare & Medicaid Services (CMS) updated Medicaid managed care regulations for the first time in over a decade. This included several new requirements for the External Quality Review (EQR) process. This issue brief reviews the updated EQR process and points out where States can…

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