Medicaid Managed Care Quarterly Reports

Performance monitoring and data analysis are critical components in assessing how well the managed care organizations (MCO) are maintaining and improving the quality of care delivered to members. The quarterly reports, with a number of elements required through oversight legislation, are comprehensive and focus on compliance areas, as well as health outcomes over time. The department examines the data from a compliance perspective and conducts further analysis if any issues are identified. While there are specific performance standards in the contract for a limited set of items, not all data reported is directly linked to a contractual requirement. Items which do have contractual requirements are indicated in the reports.