The Quality Branch within the Division of Quality and Population Health provides health care quality oversight for Kentucky’s Medicaid population.
The Quality Branch identifies opportunities for improvement in the quality of care provided for our Medicaid members. We work closely with an External Quality Review Organization (EQRO) on activities that include Contract Compliance, multi-year performance improvement projects, focus studies, validation of performance measures and provider network validations.
The Quality Branch staff and EQRO quality monitoring include:
- Analyzing the health care effectiveness data and information set scores and consumer assessment of health care providers and systems surveys of each participating managed care organization (MCO) to measure effectiveness and assess the quality of care.
- Conducting focus studies on health care quality topics.
- Monitoring and reviewing MCO performance improvement projects.
- Producing various reports showing MCO performance in relation to health care quality and outcomes.
- Offering suggestions to improve MCO quality of care and health outcomes.