Medi-Cal 管理式医疗质量改进报告
根据联邦要求，加州卫生保健服务部 (DHCS) 与外部质量审查机构 (EQRO) 签订合同，进行外部质量审查并评估 Medi-Cal 管理式医疗保健计划 (MCP) 在质量、可及性和及时性方面为受益人提供的护理。EQRO 在报告中展示了这些外部质量审查活动、结果和评估，帮助 DHCS 和 Medi-Cal MCP 了解应将资源集中在哪里以进一步提高护理质量。
会员满意度调查（CAHPS ®调查）
每份消费者对医疗保健提供者和系统的评估 (CAHPS ® )调查报告都汇总了 CAHPS ®调查的结果，该调查要求 Medi-Cal 管理式医疗受益人评估他们与医疗保健提供者的合作经历。
遭遇数据验证研究报告
遭遇数据验证 (EDV) 研究报告检查 MCP 提交给 DHCS 的遭遇数据的完整性和准确性。
管理式护理问责制/外部问责制
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
- 提高 Medi-Cal 会员的质量 – 测量年份 2023
- 加州醫療保險管理性護理計劃：2023 年各領域的品質評分
- County Behavioral Health Plan Ratings – Measurement Year 2023
MY22
- 提高 Medi-Cal 会员的质量 – 测量年份 2022
- Medi-Cal 管理式医疗计划：2022 年各领域质量评分
- County Behavioral Health Plan Ratings – Measurement Year 2022
MY21
外部质量审查技术报告和计划特定评估报告
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.
健康差异报告
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.
HEDIS ®报告
医疗保健效果数据和信息集 (HEDIS ® ) 汇总报告（也称为绩效衡量报告）提供了报告年度内的 MCP 绩效率，并使用前几年的数据进行趋势分析。该报告还将计划特定费率和总体费率与国家基准进行了比较。
预防服务报告
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.
2022 年预防服务报告有助于在公共卫生紧急情况下确定和监测 Medi-Cal 管理式医疗中儿童预防服务的适当利用情况。
The 2021 Preventive Services Report and Executive Summaryassist with identifying and monitoring appropriate utilization of preventive services for children in Medi-Cal Managed Care.
The 2020 Preventive Services Report and Addendum assesses the provision of preventive services by pediatric Medi-Cal managed care members.