Medicaid Care Management Network Adequacy
The Medicaid Quality Program conducts a variety of activities to monitor New Hampshire Medicaid beneficiaries access to care.
Standard Reports
Member Enrollment Guide to the Quality of NH Medicaid Plans
Choosing the managed care plan that works best for you and your family is important. One thing to think about before you decide is how well the different plans perform. This brief report shows how Medicaid managed care plans compare using a few of the quality measures collected by the Department of Health and Human Services.
Medicaid Care Management Quality Studies
The Office of Quality Assurance and Improvement commissions annual quality studies focusing on a wide variety of issues related to the Medicaid Care Management program.
PDF Report(s):
See archived reports here: Medicaid Care Management Quality Studies
The Medicaid Care Management Quality Updates
The Medicaid Care Management (MCM) quality updates is a MCM program outcomes focused series of presentations. These meetings are facilitated by the Office of Quality Assurance and Improvement (QAI), with various guest presenters including Managed Care Organizations or the External Quality Review Organization to review reports and answer questions. Current schedule is available in the Standard Reports section of this website.
PDF Report(s):
See archived reports here: The Medicaid Care Management Quality Updates
Medicaid Care Management Qualitative Studies
The Department of Health and Human Services (DHHS) conducts semi-annual qualitative studies that evaluate Medicaid members's experience with the Care Management Program. While the Department is pleased to conduct and release the study of these qualitative results, it is recommended to be viewed as a single point in evaluating the full membership's experience.
PDF Report(s):
See archived reports here: Member Focus Studies
External Quality Review Organization (EQRO) Technical Report
The EQRO technical report is an annual summative account of a wide variety of activities conducted to evaluate individual NH Managed Care Organization’s performance as well as evaluation of the Medicaid Care Management program.
PDF Report(s):
See archived reports here: EQRO Technical Reports
Care Management Quality Strategy
The New Hampshire Medicaid quality strategy is the foundational managed care tool that articulates managed care priorities, including goals and objectives for quality improvement. Goals and objectives are formulated in the quality strategy to assure operations of the NH Medicaid managed care quality program as well as to articulate quality improvement opportunities in those areas where performance can improve.
See archived reports here: NH Quality Strategy
MCM Directed Payment Evaluation
The Medicaid Quality Program conducts regular quality evaluations of Directed Payment programs to assure the advancement of goals and objectives in the MCM Quality Strategy.
PDF Report(s):
New Hampshire Medicaid Waiver Monitoring
The Medicaid Quality Program conducts regular monitoring of CMS 1115, 1915(b) and 1915(c) waivers to assure the advancement of goals and objectives in the MCM Quality Strategy.
Medicaid Care Management Exhibit O Quality Deliverables
DHHS utilizes Excel workbooks to manage the current list of quality deliverables required for both the medical and dental services provided by contracted managed care and dental organizations. We refer to these documents as Exhibit O Defacto versions. See links below:
New Hampshire Annual Meeting
On September 29, 2021 a group of stakeholders that include Department of Health and Human Services, Managed Care Organizations, New Hampshire Hospitals, and other providers met to discuss how to improve the rate of follow-up appointments after a patient sought treatment for substance use at the emergency department. The object of the meeting was to (1) reach consensus concerning barriers to follow-up appointments that affect the NH Medicaid rate and (2) brainstorm potential DHHS and MCO support to address barriers that impact the NH