Medicaid Cost and Quality Effectiveness

The Department of Health and Human Services shall establish a procedure to assess the various forms of health care delivery systems to measure cost effectiveness and quality. These measures must be compiled on an annual basis on identifiable benchmarks.  These measures must broadly address agency program areas and initiatives using national and state measures.  Cost effectiveness shall be determined in an actuarially sound manner and data must be aggregated in a manner to be determined by a third party.  The methodology must use appropriate case-mix and actuarial adjustments.  The department shall issue an annual healthcare report of statewide measures deemed appropriate by the department required under state and federal guidelines.  The report shall be formatted in a clear, concise manner in order to be easily understood by Medicaid beneficiaries and other stakeholders.  The annual results of the cost effectiveness calculations, quality measures and the report cards shall be made public on the department's website by December thirty-first for the prior state fiscal year.

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