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 and efficiently.
This paper is part of a larger series that updates and expands NHeLP’s 2015 Advocates’ Guide to Oversight, Transparency, and Accountability in Medicaid Managed Care. Companion papers in this series include:
- Medicaid External Quality Review: An Updated Overview (Nov. 2020)
- Finding and Analyzing Medicaid Quality Measures (Jan. 2021)
- Addressing Health Equity in Medicaid Managed Care Quality Oversight (May 2021)
- State quality fact sheets: Florida, Ohio
- Medicaid Managed Care: Using Sanctions to Improve Accountability (forthcoming)