How to Drive Compliance and Delivery System
Performance for States and Health Plans
The hard work of implementing the new Medicaid managed care regulations will fall squarely on the shoulders of states and health plans. For states, the changes come at a time when Medicaid staff are already stretched thin by budgetary constraints and the impact of the continual state and federal regulatory and innovation projects. Now states must drive and oversee new requirements, including a variety of tighter rules around encounter data quality and submission, provider network adequacy, quality rating systems, provider screenings, and program integrity. Medicaid managed care plans, meanwhile, must step up their operational, administrative, and reporting capabilities to accommodate new state oversight requirements across all aspects of the contract performance.
During this webinar, experts from HMA and CNSI will demonstrate the value of using automated dashboard technology and data analytics to establish a single electronic data and reporting portal between states and Medicaid managed care plans for the submission of data and tracking of performance – creating an efficient and centralized compliance audit trail in real time.
- Explore the requirements of the new Medicaid managed care regulations and methods for monitoring for compliance.
- View compliance solutions like MCTrack, which effectively monitors performance and creates an audit trail to meet expectations of both internal and external stakeholders and auditors.
- Learn about data analysis and an automated dashboard for tracking key performance criteria, including access to care, quality, enrollment, member and provider satisfaction, accurate encounter data and network adequacy.
- Find out about dashboards that allow regular monitoring of Medicaid pay for performance requirements, providing health plan with the ability to maximize incentives payments and withholds.
- Track and drive to completion all Medicaid managed care corrective action and quality improvement plans.
- Capture health plan readiness metrics during new contract cycles.
Heidi Robbins Brown, HMA Principal, Seattle
Diana Criss, HMA Senior Consultant, Lansing, MI
Kathleen Nolan, HMA Managing Principal, Washington, DC
Arvinder Singh, Chief Health Innovation Officer, CNSI
Who Should Attend
Medicaid directors, managed care contract managers, quality oversight directors, program integrity officials and staff; federal and state regulators and auditors; executives of Medicaid managed care plans, including compliance officers.