Performance Measures for Adults with Complex Needs

Measuring health plan and provider performance allows states to determine the quality of care that Medicaid beneficiaries are receiving and to pinpoint areas for improvement. As states develop more accountable programs for beneficiaries with complex needs, the need to augment traditional performance measures to reflect the population’s varied needs is critical. CHCS is working with innovative states and national experts to devise new measurement approaches for aged, blind, and disabled beneficiaries.

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Title and Description	Date	Type
Measuring Quality for Complex Medicaid Beneficiaries in New York State The Center for Health Care Strategies was commissioned by the United Hospital Fund to outline opportunities for establishing a comprehensive measurement approach for New York's complex Medicaid beneficiaries.		Reports
Raising the Bar: How Medi-Cal Strengthened Managed Care Contracts for People with Disabilities This report, prepared by CHCS for the California HealthCare Foundation, examines contract requirements adopted by Medi-Cal for people with disabilities, including a comparison with contracting recommendations made through a multi-stakeholder collaborative process as well as the state's rationale for contracting decisions.	September 2012	Policy & Issue Briefs
Assessment of Health Plans and Providers by People with Activity Limitations A study partially funded by CHCS modified the Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey to make it more inclusive for adults with physical, sensory, and/or cognitive disabilities.	January 2011	Technical Assistance Briefs & Tools
Performance Measurement in Fee-for-Service Medicaid: Emerging Best Practices This report synthesizes best practices from nine states for designing successful performance measurement approaches for Medicaid FFS beneficiaries, particularly those with complex needs.	October 2010	Resource Papers
Measurement Strategies for Medicaid Beneficiaries with Complex Needs This technical assistance brief describes how state purchasers can use the Agency for Healthcare Research and Quality's Prevention Quality Indicators to enhance measurement approaches for aged, blind, and disabled beneficiaries. It also looks at which HEDIS measures may be best suited for evaluating the care of beneficiaries with complex needs.	September 2009	Technical Assistance Briefs & Tools
Medicaid Best Buys: Performance Measurement for Programs Serving Adults with Disabilities and Chronic Conditions During this CHCS webinar participants heard about promising performance measurement approaches for Medicaid programs being tested by states and health plans.	July 2008	Webinar Resources
Integrated Care Program: Performance Measures Recommendations This resource paper outlines a set of recommended performance measures that can be implemented by states and health plans to assure the quality of integrated care for people who are dually eligible for Medicaid and Medicare, as well as people with disabilities who receive services solely through Medicaid.	June 2006	Resource Papers
Measuring the Effectiveness of Managed Care for Adults with Disabilities This report provides recommendations for measuring quality of care and outcomes administered by coordinated care organizations (CCOs) based on evaluations of seven CCO pilot programs in six states.	December 2005	Reports
Performance Standards for Medi-Cal Managed Care Organizations Serving People with Disabilities and Chronic Conditions This report provides a set of recommended health plan performance standards and measures that can improve how people with disabilities and chronic conditions receive services through the Medi-Cal managed care program.	November 2005	Reports
Developing Performance and Measures Standards for People with Disabilities and Chronic Conditions in Medi-Cal May 2005 - July 2008	May 2005	Initiative
Strategies for Assessing Health Plan Performance on Chronic Diseases This Resource Paper serves as a guide for Medicaid agencies who want to develop a performance measurement program using administrative data to evaluate the care provided to enrollees with chronic diseases. Maryland's experience selecting performance indicators and applying health-based risk adjustment is detailed.	March 2005	Resource Papers