Medi-Cal Managed Care品質改善報告
根據聯邦要求，加州Department of Health Care Services (DHCS)與外部品質審查組織 (EQRO) 簽訂合同，以進行外部品質審查並評估Medi-Cal Managed Care健康計劃 (MCP) 向受益人提供的護理）在質量、訪問和及時性方面。EQRO 在報告中介紹這些外部品質審查活動、結果和評估，幫助DHCS和加州醫療補助健康保健計劃 MCP 了解將資源集中在哪裡，以進一步提高護理品質。
會員滿意度調查 (CAHPS® 調查)
每份消費者對醫療保健提供者和系統的評估 (CAHPS®)調查報告都匯總了 CAHPS® 調查的結果，該調查要求Medi-Cal Managed Care受益人評估他們與醫療保健提供者的體驗。
遇見數據驗證研究報告
遭遇資料驗證 (EDV) 研究報告檢查 MCP 提交給 DHCS 的遭遇資料的完整性和準確性。
管理照顧問責任組/外部責任組
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
- 提升中醫會成員品質 — 2023 年度量
- 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
- 提高加州醫療補助健康保健計劃成員的品質 – 2022 年衡量年
- Medi-Cal Managed Care計劃：2022 年按領域劃分的品質得分
- County Behavioral Health Plan Ratings – Measurement Year 2022
MY21
外部質量審查技術報告和計劃特定評估報告
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.
健康差異報告
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.
海迪斯® 報告
醫療保健效益資料與資訊集 (HEDIS®) 彙總報告 (也稱為績效測量報告)，使用過去年數據，提供報告年度中的 MCP 績效率和趨勢。該報告還將計劃特定和綜合費率與國家基準進行比較。
預防服務報告
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 年預防服務報告協助確定和監察在公共衛生緊急情況下為醫療管理服務中兒童適當的使用預防服務。
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.