Quality Measures
Cal MediConnect health plans will be required to report measures that examine access and availability, care coordination/transitions, health and well-being, mental and behavioral health, patient-caregiver experience, screening and prevention, and quality of life.
Click on the link below to download the full list of quality measures that will be tracked over the course of California’s three-year Cal MediConnect program.
Evaluation
CMS has contracted with an independent evaluator to measure, monitor, and evaluate the impact of the Duals Integration Demonstrations implemented nationally and in California. The evaluator will assess how the California’s initiative operates, how it transforms and evolves over time, and beneficiaries’ outcomes, perspectives and experiences.
Target areas of the evaluation include (but are not limited to):
- Beneficiary health status and outcomes;
- Quality of care provided across care settings;
- Beneficiary access to and utilization of care across care settings;
- Beneficiary satisfaction and experience;
- Administrative and systems changes and efficiencies;
- Long-term care rebalancing and diversion effectiveness; and
- Overall costs or savings for Medicare and Medicaid
Background Resources
The following documents contain quality and evaluation information relevant to the dual eligible population.
- Strategies Approach to Performance Measurement for Dual Eligible Beneficiaries (National Quality Forum/June 2012) The report describes a measurement framework specific to dual eligible beneficiaries, assesses current quality measures and measurement efforts, and considers potential new quality measures.
- Long-Term Services and Supports Performance Measurements & Standards (NASUAD/June 2012) This document contains a comprehensive list of existing performance measures for LTSS.
- Special Needs Plans: Structure & Process Measures (National Committee for Quality Assurance) The report highlights structure and process measures for evaluating MA Special Needs Plans (MA-SNPs).
- Raising Expectations: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers (AARP/September 2011) This report measures state-level performance on multiple dimensions of long-term services and supports systems that provide assistance to older people and adults with disabilities.