CHCS - Center for Health Care Strategies

Improving the quality and cost-effectiveness of publicly financed health care

Health Plan Quality Improvement

Continuous quality improvement ensures an ongoing focus on positive outcomes and evidence-based practices. Since April 2000, over 180 Medicaid managed care organizations in 41 states have collaborated through CHCS’ Best Clinical and Administrative Practices (BCAP) Quality Framework to design and evaluate quality improvement activities. CHCS resources include best practice toolkits and case studies to help states and health plans develop and implement quality improvement programs.

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Title and Description Date Type

Improving Medicaid Managed Care for Youth with Serious Behavioral Health Needs: A Quality Improvement Toolkit

This toolkit shares promising practices tested by plans participating in CHCS' Collaborative on Improving Managed Care Quality for Youth with Serious Behavioral Health Needs, an initiative designed to improve care for children and youth, and the resulting impact on access, care, and avoidance of unnecessary services and costs.

September 2009 Toolkits

The National Health Plan Collaborative Toolkit

The National Health Plan Collaborative created this toolkit of resources, lessons, best practices, and case studies to help other health plans reduce racial and ethnic health disparities.

September 2008 Toolkits

The National Health Plan Collaborative: Featured in the Joint Commission Journal on Quality and Patient Safety

This article discusses how the health plans participating in the National Health Plan Collaborative (NHPC) were able to overcome initial challenges in obtaining information on race/ethnicity of their enrollees and examined their diabetes performance measure to assess disparities in care.

May 2008 Journal Articles

Reducing Racial and Ethnic Disparities: Quality Improvement in Medicaid Managed Care Toolkit

This toolkit details the experiences of a collaborative workgroup of Medicaid managed care organizations, Improving Health Care Quality for Racially and Ethnically Diverse Populations. The workgroup was directed by CHCS and funded by the Robert Wood Johnson Foundation and The Commonwealth Fund.
January 2007 Toolkits

Resources from the Toolkit: Reducing Racial and Ethnic Disparities - Quality Improvement in Medicaid Managed Care

The following are supplementary resources from the toolkit, Reducing Racial and Ethnic Disparities: A Quality Improvement Initiative in Medicaid Managed Care. 

January 2007 Technical Assistance Briefs & Tools

Resources from the 2006 CHCS Quality Summit

Download presentations from the 2006 CHCS Quality Summit -- a national showcase of best practices in reducing disparities and improving health care quality for all.
December 2006 Meeting Highlights

Improving Asthma Care for Children Toolkit: Best Practices in Medicaid Managed Care

This toolkit includes strategies for improving asthma care tested by a diverse group of health plans and states serving Medicaid consumers.

July 2006 Toolkits

Resources from the Toolkit: Improving Asthma Care for Children - Best Practices in Medicaid Managed Care

The following are supplementary resources from the toolkit, Improving Asthma Care for Children: Best Practices in Medicaid Managed Care.

July 2006 Technical Assistance Briefs & Tools

BCAP Quality Framework

The BCAP Quality Framework offers a systematic approach to improve quality within Medicaid managed care.
June 2006 Technical Assistance Briefs & Tools

BCAP Quality Workbook

The BCAP Quality Workbook helps organizations incorporate measurement strategies into initial project design and evaluate ongoing progress of quality efforts.
April 2006 Technical Assistance Briefs & Tools

Inland Empire Health Plan: Using Performance Incentives to Improve Preventive and Chronic Care

Inland Empire Health Plan, a nonprofit HMO in California's Riverside and San Bernardino counties, is a veteran among Medicaid health plans in its use of provider incentives.

March 2006 Case Studies

SoonerCare: Improving Care for Native Americans with Diabetes

Through participation in the Improving Health Care Quality for Racially and Ethnically Diverse Populations BCAP workgroup, SoonerCare set a goal to improve care for adult Native Americans in Oklahoma with diabetes. 

January 2006 Case Studies

Alameda Alliance for Health: Leading a Collaborative Effort Against Asthma

This participant in CHCS' California Asthma Collaborative has realized significant gains in its quality measures for children with asthma as a result of new partnerships with providers, community-based organizations, and Children's Hospital Oakland.

November 2005 Case Studies

Hudson Health Plan: Improving Preventive and Dental Care for Adults in Need

Hudson Health Plan set a goal to improve primary and dental care for adults with special care needs as part of a Best Clinical and Administrative Practices workgroup. The plan increased primary care visits from 67 percent in 1999 to 74 percent in summer 2005 and primary dental visits from 42 percent to 53 percent.

November 2005 Case Studies

Enhancing Child Development Services in Medicaid Managed Care: A BCAP Toolkit

This toolkit reflects the experiences of the Enhancing Child Development Services in Medicaid Managed Care workgroup - 10 health plans and a primary care case management program - that collaborated to develop best practices for enhancing child development services.
October 2005 Toolkits

Standardizing Disease Management Reporting for a Multi-State Plan

Molina Healthcare, Inc., a rapidly growing health plan specializing in Medicaid and SCHIP, applied the BCAP Typology to develop a standardized approach to quality improvement for members with asthma and diabetes in California, Michigan, Utah, and Washington.

August 2005 Case Studies

National Health Plan Collaborative

December 2004 - October 2008

December 2004 Initiative

Molina Healthcare of Michigan's Step-by-Step Improvement in Early Childhood Assessment

This case study describes how Molina Healthcare of Michigan applied the BCAP Quality Framework to improve EPSDT rates and early childhood developmental screening for Medicaid enrollees from birth to age three.
November 2004 Case Studies

BCAP Pilot Planning Form

This BCAP Pilot Planning Form provides a simple planning template to use when developing new quality improvement initiatives.
October 2004 Technical Assistance Briefs & Tools

Improving Managed Care for Children with Special Needs: A BCAP Toolkit

This Toolkit includes a process for implementing quality improvement projects for caring for children with special needs; strategies for identification, stratification, outreach, and intervention, including plan case studies; and tools from workgroup participants
October 2004 Toolkits
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