Issue link: https://beckershealthcare.uberflip.com/i/1255100
38 QUALITY IMPROVEMENT & MEASUREMENT Quality improving among Medicaid managed care plans: 3 study findings By Mackenzie Bean M edicaid managed care plans — which serve two-thirds of all Medicaid enrollees — have consistently improved performance on more than 25 quality metrics since 2014, according to a March 3 report from America's Health Insurance Plans. e Menges Group, a healthcare consulting firm, conducted the research on behalf of AHIP. Researchers analyzed Medicaid man- aged care plan performance for 30 Health- care Effectiveness Data and Information Set and CAHPS quality measures between 2014 and 2018. Data sources included the Kaiser Family Foundation and the National Committee for Quality Assurance's Medicaid Quality Compass database. ree report takeaways: 1. Medicaid managed care plans improved performance on 26 of the 30 HEDIS and CAHPS measures between 2014 and 2018. e four measures that did not see improve- ment were: • Childhood immunization status • Asthma medication ratio • Prenatal and postpartum care • Use of imaging studies for low back pain 2. In 2018, 77.2 percent of Medicaid man- aged care enrollees were NCQA-accredited health plans, compared to just 71.4 percent in 2015. 3. Twenty-four states withhold a small portion of capitation payments to incentivize Medicaid managed care plans to meet or exceed quality metrics. Twenty-three states also offer bonus payments based on quality performance. n Civica Rx investor gives Penn Nursing $6M to study care model By Mackenzie Bean T he University of Pennsylvania's School of Nursing will at- tempt to replicate and study its own transitional care model at four other health systems through a $6 million grant from Arnold Ventures, a Houston-based foundation known for investing in the nonprofit generic drug company Civica Rx. Four things to know: 1. Leaders at Philadelphia-based Penn Nursing developed the care model, which has proven to reduce readmissions, improve outcomes and lower health costs among Medicare populations in past clinical trials. The program relies on advanced practice registered nurses who work with patients and other care team members to build individualized care plans for older patients leaving the hospital with complex health and social needs. 2. The study will assess the outcomes of 1,600 Medicare pa- tients participating in the transitional care model at nine hospi- tals affiliated with the following systems: • Swedish Health Services (Seattle) • Trinity Health (Livonia, Mich.) • University of California San Francisco Health • Veterans Health Administration (Washington, D.C.) 3. Penn Nursing leaders will help implement the program and train employees at all study sites. 4. The research's overall goal is to see if the care model is replicable across hospitals nationwide, which could prove to be a valuable strategy for CMS and other insurers to reduce healthcare costs. n Mount Sinai creates center for COVID-19 recovery By Anuja Vaidya N ew York City-based Mount Sinai Health System opened a center May 13 to help patients recovering from COVID-19 and study the disease's long-term effects. The Center for Post-COVID Care was designed to help COVID-19 patients transition from the hospital to their homes. The center is also open to patients who were never hospitalized but need help during their recovery. At the center, patients will be offered a personal- ized treatment plan that includes input from sev- eral specialties, including primary care, pulmonary medicine, cardiology, infectious disease and phys- iatry, as well as social workers and pharmacists. The center will also focus on evaluating the long- term effects of the disease, which are largely unknown. Mount Sinai will create a COVID-19 registry and collect information on sociodemo- graphics, behaviors, underlying conditions, mental health conditions and medications from patients with the disease. "This center will provide a unique opportunity to follow this population and systematically evaluate the long-term impact of COVID-19," said Dennis S. Charney, MD, president for academic affairs at Mount Sinai Health System. n