Tshaj tawm
Rov qab mus rau Lub Kaum Ob Hlis 2021 Cov Neeg Koom Tes Kev Sib Txuas Lus Hloov Kho
Managed Care Performance Monitoring Dashboard Report
The October release of the Managed Care Performance Monitoring Dashboard was published on the California Health & Human Services Agency Open Data Portal on November 1. The dashboard is a monitoring tool produced quarterly that includes comprehensive data on a variety of measures, such as enrollment, health care utilization, appeals and grievances, network adequacy, and quality of care. Information in the dashboard assists DHCS and its stakeholders with observing and understanding MCP performance statewide. The October release reports on monthly enrollment, demographics, and hearings totals from April 2020 to March 2021, monthly utilization totals from October 2019 to September 2020, and quarterly grievance totals from mid-2019 to early 2021.
Quality Incentive Pool (QIP) Qhov Kev Kawm Xyoo Peb (PY3) Daim Ntawv Qhia Kev Ntsuam Xyuas
Thaum Lub Kaum Hli Ntuj hnub tim 29, DHCS tau xa daim ntawv qhia txog kev ntsuam xyuas QIP PY3 mus rau CMS thiab muab tso rau hauv lub vev xaib DHCS. Txij li Lub Xya Hli 1, 2017, DHCS tau hais kom Medi-Cal MCPs them nyiaj txhawb nqa zoo raws li kev ua tau zoo rau 17 lub tsev kho mob pej xeem uas tau xaiv tseg (DPH) koom nrog raws li lawv qhov kev ua tau zoo ntawm tsawg kawg 20 qhov kev ntsuas zoo uas hais txog kev saib xyuas thawj zaug, kev kho mob tshwj xeeb, thiab kev kho mob hauv tsev kho mob, suav nrog kev ntsuas kev siv cov peev txheej tsim nyog. Yuav kom tau txais cov nyiaj them QIP, DPHs yuav tsum ua tiav cov hom phiaj txhim kho tshwj xeeb. Hauv PY3, lub sijhawm ntsuas thiab cov hom phiaj them nyiaj tau hloov kho nrog CMS kev pom zoo vim yog COVID-19. Cov tsev kho mob tuaj yeem tau txais nyiaj them tag nrho yog tias lawv qhov kev ua tau zoo tshaj qhov txwv, txawm tias qhov kev ua tau zoo tsis zoo dua li xyoo dhau los. Daim ntawv ntsuam xyuas PY3 muab kev sib piv ntawm PY2 thiab PY3 rau qhov zoo ntawm cov kev pabcuam pw hauv tsev kho mob thiab cov kev pabcuam sab nraud uas muab rau cov tswv cuab Medi-Cal ntawm DPHs. DHCS pom tias txhua tus tsuas yog ib tus DPH (94 feem pua) tau ua tiav lawv lub hom phiaj them nyiaj rau tag nrho 20 qhov kev ntsuas, thiab muaj kev txhim kho tag nrho rau ntau dua ib nrab ntawm cov kev ntsuas (61 feem pua).