The Medicaid Quality Program conducts a variety of activities to monitor New Hampshire Medicaid beneficiaries access to care.
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.
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.
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.
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.
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.
The New Hampshire Medicaid Care Management Quality Strategy is technical document required by the Code of Federal Regulations, CFR438.200, and the Center for Medicare and Medicaid Services programs to ensure the delivery of quality health care by managed care organizations. While the overview of quality activities are addressed, the document is not intended to comprehensively describe all the activities that DHHS undertakes to ensure Medicaid program quality.
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.
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.
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