Inicio Datos y estadísticas Reportes de Datos y Estadísticas del DHCS Reportes de mejora de la calidad de Medi-Cal Managed Care​​ 

Medi-Cal Managed Care Informes de mejora de la calidad​​ 

Volver a Monitoreo de Atención Administrada​​ 

In accordance with federal requirements, the California Department of Health Care Services (DHCS) contracts with an external quality review organization (EQRO) to conduct external quality reviews and evaluate the care provided to beneficiaries by Medi-Cal managed care health plans (MCPs) in the areas of quality, access, and timeliness. The EQRO presents these external quality review activities, results, and assessments in reports that help DHCS and Medi-Cal MCPs understand where to focus resources to further improve the quality of care.​​ 

Encuestas de Satisfacción de los Miembros (Encuestas CAHPS®)​​ 

Each Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey report aggregates the results of CAHPS® surveys, which ask Medi-Cal managed care beneficiaries to evaluate their experiences with their health care health care providers.​​ 

Informes de estudio de validación de datos de encuentros​​ 

Encounter Data Validation (EDV) Study Reports examine the completeness and accuracy of the encounter data submitted to DHCS by the MCPs.​​ 

Conjuntos de Responsabilidad de Atención Gestionada / Conjuntos de Responsabilidad Externa​​ 

The Managed Care Accountability Sets (MCAS) / External Accountability Set (EAS) is a set of performance measures that DHCS selects for annual reporting by Medi-Cal MCPs.​​ 

MY23​​ 

MY22​​ 

MY21​​ 

Revisión de calidad externa, informes técnicos e informes de evaluación específicos del plan​​ 

The EQRO annually prepares an independent external quality review technical report that analyzes and evaluates aggregated information on the health care services provided by Medi-Cal MCPs. As part of the external quality review technical report, the EQRO prepares a plan-specific evaluation report of each of MCP.

Access these reports on the Medi-Cal Managed Care External Quality Review Technical Reports with Plan-Specific Evaluation Reports.​​ 

Informes de disparidad de salud​​ 

The Health Disparity Reports identify and understand health disparities affecting California’s Medi-Cal managed care members and are based on focused studies conducted annually by the EQRO. The reports analyze Managed Care Accountability Set (MCAS) measure results reported by Medi-Cal managed care plans (MCPs) for various demographic categories.​​ 

Informes HEDIS®​​ 

El Reporte Agregado del Conjunto de Datos e Información de Eficacia en Salud (HEDIS®), también conocido como Reportes de Medición del Desempeño, proporciona las tasas de rendimiento de los MCP durante un año de reporte y tendencias empleando datos de años anteriores. El reporte también compara las tasas específicas y agregadas de los planes con los referentes nacionales.​​ 

Informe de Servicios Preventivos​​ 

The 2024 Preventive Services Report and Executive Summary assists with identifying and monitoring appropriate utilization of preventive services for children in Medi-Cal Managed Care through the public health emergency​​ 

The 2023 Preventive Services Report and Executive Summary assists with identifying and monitoring appropriate utilization of preventive services for children in Medi-Cal Managed Care through the public health emergency.​​ 

El Informe de Servicios Preventivos 2022 ayuda a identificar y monitorear la utilización adecuada de los servicios preventivos para niños en Medi-Cal Managed Care durante la emergencia de salud pública.​​ 

El Reporte de Servicios Preventivos de 2021 y el Resumen Ejecutivoayudan a identificar y monitorear la utilización adecuada de los servicios preventivos para los niños inscritos en Medi-Cal Managed Care.​​ 

The 2020 Preventive Services Report and Addendum assesses the provision of preventive services by pediatric Medi-Cal managed care members.​​