From Susan

First and foremost, I want to recognize Healthcare Quality Week as the special time each year we celebrate our colleagues who work in and support healthcare quality. Raising the bar in healthcare quality standards is what we do!

MHR is unique in that the majority of our consultants for NCQA accreditation are also NCQA surveyors. We maintain our expertise through participating in NCQA surveyor training and continuous quality improvement within our team.  See our Quality Insights to learn what NCQA will closely scrutinize in upcoming surveys because of their importance to healthcare quality.

As 2024 quickly approaches, it’s time to schedule your annual training updates with MHR. You can easily contact us through our website or ask your MHR consultant.

I am looking forward to meeting many of you at our MHR-hosted client dinner meeting on October 24 at NCQA’s Health Innovation Summit in Orlando, Florida. I value our face-to-face meetings and hearing your feedback.

Contact me to see how we can help you.

Susan K. Moore, President & CEO

NEWS

 Protecting Patients from Surprise Medical Bills

Preliminary Overview of State Assessments Regarding Compliance with Medicaid and CHIP Automatic Renewal Requirements at the Individual Level, as of September 21, 2023

Ensuring Continuous Eligibility for Medicaid and CHIP: Coverage and Cost Impacts for Children

Trust, problem resolution linked to MA member renewals, study finds

What Share of Nursing Facilities Might Meet Proposed New Requirements for Nursing Staff Hours?

Engaging Community Coalitions to Decrease Opioid Overdose Deaths Practice Guide 2023

United Healthcare Enhances its Ucard for 2024: 4 Updates

Why BCBS Michigan is Cutting 20% of Prior Authorization Requirements

6 Grocers with Medicare Advantage Plans

Detailed Data for Hundreds of American Indian and Alaska Native Tribes

Eight Hispanic Groups Each Had a Million or More Population in 2020

New Census Bureau Data Product Measures Communities’ Social Vulnerability and Equity

Factors Influencing 2024 Individual Market Premiums

Making “Birthing While Black” Safe, Equitable

There’s Still Room for Improvement on Adult Vaccination Rates

UPCOMING INDUSTRY EVENTS

October 15-21, 2023
Healthcare Quality Week (HQW)
NAHQ

October 15-17, 2023
The 13^th Annual HEDIS® & Quality Improvement Summit
RISE

• New Orleans

October 17, 2023
Risk Adjustment Gets Useable Data At Last
AHIP

• Webinar

October 23-25, 2023
NCQA Health Innovation Summit
NCQA

• Orlando, FL

October 23, 2023
In Conversation: How Leading Health Insurance Providers Engage With LGBTQ+ Members
AHIP

• Webinar

October 25-26, 2023
PHA Innovation Summit
Population Health Alliance

•  Washington, D.C.

October 25, 2023
Is Your Provider Directory Offering Inclusive Access for LGBTQ+ Members?
AHIP

• Webinar

November 9, 2023
Health Equity Accreditation Plus
NCQA

• Live Webinar

November 14-15, 2023
Population Health Summit
RISE

• Tampa, FL

November 16, 2023
Race, Ethnicity, SOGI, Income, and Language in Patient Reg
NCQA

• Live Webinar

December 4-6, 2023
The Second Annual Social Determinants of Health Policy Forum
RISE

• Washington D.C.

December 5, 2023
Innovations in Chronic Care Management: The Analytics Behind Better Health Outcomes
RISE

• Webinar

March 12-14, 2024
2024 Medicare, Medicaid, Duals, & Commercial Market Forum
AHIP

• Baltimore, MD

April 19-22, 2024
2024 National Conference American Case Management Association

• Nashville, TN

June 11-13, 2024
AHIP 2024
AHIP

• Las Vegas, NV

QUALITY INSIGHTS

In our recent NCQA surveyor training, we heard that NCQA Standards on Q&Q Analysis and System Controls for Health Plan Accreditation are a top focus for upcoming surveys!

• Do your qualitative analyses include complete descriptions of barriers, conclusions to findings, and roles of the staff, among other required factors?
• Do your quantitative analyses for NCQA standards QI 3 and QI 4 on continuity and coordination of care measure effectiveness for each measurement cycle?
• Do your policies, procedures, and analyses on utilization management and credentialing system controls meet standards?
• Are you overseeing your delegates’ UM, appeal, and CR systems, documenting findings, and improving upon opportunities?

See our May 2023 blog on Q&Q Analysis and July 2023 blog on System Controls.

MHR knows what is needed. Contact us to help you meet requirements to maximize your survey scores.

Models of Care (MOC) for Special Needs Plans (SNPs) are due for submission in February 2024.  Are you ready?

Jean Lockington is an MHR Independent Consultant and also an NCQA Executive Reviewer for MOC.  Now is the time to seek her expertise in helping you prepare for your submission in February. She will assess each element against the standards for either your initial or off-cycle MOC.

See our March 2023 blog for tips when developing your MOC.

CALENDAR OF OBSERVANCES

Month Awareness Calendar for Population Health Management Activity Ideas

October

National Bullying Prevention Month

Breast Cancer Awareness Month

Healthcare Quality Week (10/15-10/21/2023)

White Cane Safety Day (10/15)

Health Literacy Month

November

Great American Smoke Out (11/16/2023)

American Diabetes Month

December

World Aids Day (12/1)