Women's Health
Prenatal Care in Indiana
FSSA has taken various actions to improve the number of healthy babies born to Medicaid mothers, the single most important priority for its Hoosier Healthwise program. In 2007, targeted bonus payments for prenatal care became available to the managed care organizations (MCO) to emphasize its importance. The Office of Medicaid Policy and Planning (OMPP) created a quality improvement committee composed of OMPP and community stakeholders (see “Quality Strategy” below). Based on the group’s efforts to identify barriers and propose solutions, Medicaid has moved forward with a plan to reduce smoking among pregnant women and has recently developed a single risk-assessment form to be used by providers to identify risk factors for complicated pregnancies early on. Each month FSSA tracks the percentage of women receiving prenatal care, as of April 2008, 80% of pregnant women enrolled with an MCO were receiving prenatal care.
Update on Presumptive Eligibility
To read the letter to the Presumptive Eligibility Advisory Group and Related Stakeholders, 5-29-08 (click here)
Quality Strategy
The Center for Medicaid and Medicare Services (CMS) requires that each State that enters into one or more managed care organization (MCO) contracts must develop a Quality Strategy. The Strategy must address:
- How the State will assess the quality of care delivered
- How the State, based on its assessment, will improve the quality of care delivered
CMS also requires that States obtain the input of recipients and other stakeholders in the development of the Quality Strategy and make the Quality Strategy available for public comment before adopting it as final.
Under the direction of the Office of Medicaid Policy and Planning (OMPP), a group of Indiana stakeholders, including representatives from the Indiana State Department of Health (ISDH), the Indiana Department of Mental Health and Addiction (DMHA), the Hoosier Healthwise Managed Care Organizations and Managed Behavioral Health Organizations (Anthem/Magellan, MDwise/CompCare, Managed Health Services/Cenpatico), providers, academics, and other stakeholders drafted this 2007-2008 Hoosier Healthwise Quality Strategy.
- Quality Strategy Plan
- Appendix A Hoosier Healthwise Eligibility Summary
- Appendix B HEDIS Results
- Appendix C Hoosier Healthwise Member Survey Results Summary
- Appendix D MCO Contract Pay for Performance Summary
- Appendix E MCO Contract Reporting Requirements Summary
- Appendix F MCO Contract Non-compliance Remedies
- Appendix G Sample Dashboard Report
