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Using EQROs to Improve the Quality of Preventive and Developmental Services

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This document discusses using external quality review organizations (EQROs) to improve the quality of preventive and developmental services for children in Medicaid managed care plans. It finds that while states are required to assess quality, most current EQRO reports provide only basic data without interpretation. The document provides guidance to states on developing quality strategies and contracts with EQROs that specifically focus on preventive and developmental services for children, such as measuring developmental screening rates and referral outcomes. States can better utilize EQROs and federal regulations to improve children's healthcare quality by undertaking strategic planning with stakeholder input.

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Using EQROs to Improve the Quality of Preventive and Developmental Services Henry T. Ireys, Tara Krissik Anne Markus, Sara Rosenbaum Annual Conference of the National Academy of State Health Policy Denver, Colorado October, 2007
Children in Medicaid Managed Care ,[object Object],[object Object],[object Object],_______ *Urban Institute and Kaiser Commission for the Uninsured, 2007 ** Centers for Medicaid and Medicare Services, 2006
Take-Home Message ,[object Object],[object Object],[object Object]
Overview of Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Policy Context: Current CMS Regulations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Role of External Quality Review Organizations (EQROs) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CMS Toolkits ,[object Object],[object Object],[object Object],[object Object],[object Object]
Previous Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Study Questions ,[object Object],[object Object],[object Object],[object Object]
Principal Findings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Current Study ,[object Object],[object Object],[object Object]
Findings ,[object Object],[object Object],[object Object],[object Object],[object Object]
Findings, continued ,[object Object],[object Object],[object Object],[object Object]
Skills Needed by EQROs ,[object Object],[object Object],[object Object],[object Object]
Scope of Work Specifics ,[object Object],[object Object],[object Object],[object Object]
Scope of Work Specifics, cont’d ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Implications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Guidance for States ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Editor's Notes

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