Quality

Measures of Focus

MCC of FL’s goal is to work with our providers to improve the health of the members we serve.
In addition to other accreditation or regulatory measures, MCC of FL will monitor the following priority measures:

– Prenatal and Postpartum Care

– Birth Outcomes (C-Section, Elective Delivery and Neonatal Abstinence Syndrome)

– Well Child

– Diabetes Monitoring

– Adult and Child Access to Care

– Potential Preventable Events (ER Visits, Hospital Admits, Hospital Readmits)

– Follow-up after ER or Hospitalization

If you have any questions about any of the performance measures that Magellan Complete Care will monitor, you may contact our Network Team at (800) 424-8584.

 

MCC of FL: HEDIS® 2019 Results for Measurement Year 2018

The Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used set of performance measures in the managed care industry. Developed by the National Committee for Quality Assurance (NCQA®). Magellan Complete Care of Florida closely monitors the HEDIS rates as a way to help us identify opportunities for us to improve the health of our members. Below is a list of those improvements for 2019 compared to 2018.

– 4% more members with diagnosis of schizophrenia maintained their treatment with anti-psychotic medication

– 17% more members had an eye retinal exam

– 6% more members continued their statin medication in order to keep under control cardiovascular conditions

– 7% more members maintained their asthma treatment with the appropriate medication

– 6% more members maintained their treatment for depression

– 3% more members received the appropriate care to control their blood pressure

Visit the AHCA website to learn more about the Performance Measure Data submissions for Medicaid

 

Quality Performance Guide 2020

Quality Performance Guide 2020 – Your guide to HEDIS®, CAHPS®, and Coding Accuracy

 

 

FDR Compliance Attestation

Telehealth Attestation form

 

 

Rights and Responsibilities

The MCC of FL Provider Handbook includes provider responsibilities related to member rights and responsibilities. Please review your provider handbook for a full list of your rights and responsibilities as an MCC of FL provider.