DHCS Comprehensive Quality Strategy
The mission of the Department of Health Care Services (DHCS) is to provide Californians with access to affordable, integrated, high-quality health care, including medical, dental, mental health, substance use treatment services and long-term care. The Department's vision is to preserve and improve the overall health and well-being of all Californians. Quality improvement is a key component to achieving this mission and vision.
The Medicaid Managed Care and CHIP Managed Care Final Rule (Final Rule), at 42 Code of Federal Regulations 438.340, requires each state Medicaid agency to implement a written quality strategy to assess and improve the quality of health care and services furnished by all Medicaid managed care entities in that state. In 2018, the Department wrote the
Med-Cal Managed Care Quality Strategy Report in response to this requirement. To update this report, DHCS combined updates from the
Medi-Cal Managed Care Quality Strategy Report with updates and revisions to the
DHCS Strategy for Quality Improvement in Health Care report, and created the
State of California Department of Health Care Services Comprehensive Quality Strategy (CQS) report. The CQS outlines the Department's process for developing and maintaining a broader quality strategy to assess the quality of care that all of our beneficiaries receive, regardless of delivery system, and defines measurable goals and tracks improvement while adhering to the regulatory managed care requirements of 42 Code of Federal Regulations (CFR) 438.340. The CQS covers all Medi-Cal managed care delivery systems, including the Medi-Cal managed care plans, county mental health plans, Drug Medi-Cal Organized Delivery System, and the dental managed care plans, as well as non-managed care departmental programs. The report also highlights delivery system reform; the coordination of efforts to improve performance on behavioral health CMS Core Set quality measures; and the proposed California Advancing and Innovating Medi-Cal (CalAIM), a multi-year initiative by DHCS to implement overarching policy changes across all Medi-Cal delivery systems.
The public will be invited to review and provide feedback on the CQS report from November 18, 2019 to December 23, 2019. Please send any questions or comments to:
DHCSComprehensiveQualityStrategy@dhcs.ca.gov.
Any comments received are public documents and may be posted on this webpage.
Proposed
State of California Department of Health Care Services Comprehensive Quality Strategy Report
Please visit this webpage for more information on other DHCS' quality measures efforts and reports (e.g. monitoring reports and External Quality Review Organization reports).
NOTE:
The DHCS Comprehensive Quality Strategy (CQS) has been revised based on comments received, but finalization of the CQS has been delayed to allow inclusion of additional details related to COVID-19 and the resulting California Advancing and Innovating Medi-Cal (CalAIM) implementation delay. We plan on finalizing and submitting the final CQS to CMS in 2021.
2018 Quality Strategy Reports (PDFs)
Presentations (PDFs)
External Resources
