Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 482 - NEBRASKA MEDICAID MANAGED CARE
Chapter 6 - QUALITY
Section 482-6-004 - IMPROVEMENT
Universal Citation: 482 NE Admin Rules and Regs ch 6 ยง 004
Current through September 17, 2024
Based on the results of assessment and monitoring of quality and appropriateness of care and contract compliance, the Department will target improvement efforts.
004.01. INTERVENTIONS FOR IMPROVEMENT. The Department will utilize, but is not limited to the following interventions to improve the quality and appropriateness of care:
(A)
Quality Committee: The Department has established a Quality
Committee;
(B) Performance
Improvement Projects: The health plans are required to conduct at least two
clinical and one non-clinical projects annually. For each project, the
Department with the Quality Management Committee will choose the topic, develop
the study methodology and determine interventions to reach improvement goals.
Each plan will conduct the same project, at least one will be a joint project
with another plan (See 482-000-11);
(C) Quality Performance Dashboard: In an
effort to monitor a health plans performance on quality measures, a quality
performance dashboard was developed. The dashboard approach provides a
framework for benchmarking performance and assists health plans to prioritize
quality improvement planning. The dashboard gives a multi-dimensional view of a
health plans performance by comparing quality measures to national standard
measures, if appropriate, to baseline measures for the program, and over two
years. The dashboard results will display on the Department's website;
and
(D) Health plans sanctions-See
482 NAC 6-003.04(A).
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