Promoting Quality in Medicaid Transformation

The role of Medicaid in promoting access to high-quality, high-value maternity care.

One of the most challenging aspects of health care improvement and reform is ensuring that individuals, particularly those who are vulnerable and low income, have access to care. Just as challenging is the imperative to ensure that the care accessed is of the highest quality possible. The Institute of Medicine (IOM) report, Crossing the Quality Chasm, identified the primary goal of any high-qua...

Medicaid disease management: seeking to reduce spending by promoting health.

Over the past two years, states across the country have been struggling to cope with rising Medicaid expenditures and, in some cases, significant budget shortfalls. They have sought to cut Medicaid spending by limiting benefits, increasing costsharing, and slowing provider payment increases. A number of states have also tightened Medicaid eligibility standards or have delayed planned eligibilit...

Quality assurance for Medicaid managed care.

An overview of Wisconsin Medicaid quality.

58 Introduction Almost 100 years have passed since E. A. Codman advocated evaluation of care provided to patients. Donebedian1 provided a set of criteria for measuring quality, and the Institute of Medicine provided a definition of quality.2 Quality of care measurement has different parameters for patient, provider, and purchaser. Physicians are interested in evidence-based knowledge to drive p...

Estimating ROI for Medicaid Quality Improvement Programs