The branch works with the external quality review organization (EQRO) to monitor the quality and effectiveness of care provided Kentucky Medicaid members enrolled in a managed care organization (MCO).
The Managed Care Oversight 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 MCO to measure effectiveness and assess quality of care,
- Conducting two 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.