Cervical Cancer Screening – The percentage of women 21–64 years of age who were screened for cervical cancer using either of the following criteria:
• Women age 21–64 who had cervical cytology performed every 3 years.
• Women age 30–64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years.
Further reading
Preston Cody is the featured panelist for the upcoming Washington State Medicaid Spotlight Webinar on Monday, August 7th. RESERVE your seat today!
Medicaid Who’s Who: Preston Cody – Division Director, Division of Medicaid Program Operations and Integrity, Washington State
1. What segment of the industry are you currently involved?
A: Medicaid Program Integrity, Medicaid Managed Care, value-based payment, network adequacy, physical/behavioral health integration, mental health parity, Medicaid Administrative Claiming, Non-emergency Medical Transportation, Interpreter Services, and other activities related to Medicaid Program operations.
2. What is your current position and with what organization?
A: Division Director, Division of Medicaid Program Operations and Integrity, Washington State Health Care Authority (the single state Medicaid agency in WA)
3. How many years have you been in the Medicaid industry?
A: 20+
4. What is your focus/passion? (Industry related or not)
A: I’m passionate about ensuring the clients we serve receive the best care possible and those staff who serve clients on a daily basis get the direction, tools and support to do their jobs effectively with a high-level of satisfaction. As a veteran I serve as the executive sponsor for the agencies Veterans Employee Resource Group which focuses on recruiting, retaining and supporting our veteran employees. I find this an extremely rewarding process.
5. What is the top item on your “bucket list?”
A: Simply to live each day to the fullest and enjoy the journey.
6. What do you enjoy doing most with your personal time?
A: On a personal note, I am happily married and have five children and two grandchildren who I love spending time with. My family and I love to camp, boat and ride ATV’s on the Pacific Northwest coast, it’s an amazing place to live! However, during football season we switch gears to watch our beloved Seattle Seahawks. Go Hawks! Work-life balance is critically important and something we encourage staff to focus on in our agency.
7. What is your favorite junk food?
A: Any type of Mexican food, it’s all amazing!
8. Of what accomplishment are you most proud?
A: Effectively transition the WA State subsidized Basic Health program to Medicaid coverage under the ACA effective 1/1/2014.
9. For what one thing do you wish you could get a mulligan?
A: Great question. Years ago our organization was directed by our state Legislature to immediately terminate coverage for a large group of clients with less than 1 day notice. We complied with the requirement which was immediately challenged and was ultimately settled years later. If I had the opportunity for a do over I would have done a better job describing the impact and delaying implementation which would have accomplished the same outcome with far less disruption and ensured clients received timely due process.
10. What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?
A: 1. Ensuring there is no erosion of coverage resulting in a decrease in population health, increased uncompensated care and massive disruption in the health care system.
2. Effective implementation of behavioral and physical health integration in WA Medicaid.
3. Completion of the first year of value-based payment requirements with our managed care organizations.
Preston Cody is the featured panelist for the upcoming Washington State Medicaid Spotlight Webinar on Monday, August 7th. RESERVE your seat today!
Adolescent Well-Care Visits – The percentage of enrolled members 12–21 years of age who had at least one comprehensive well-care visit with a PCP or an OB/GYN practitioner during the measurement year.
Further reading
http://www.ncqa.org/portals/0/Adolescent%20Well-Care%20Visits.pdf
Disease-Modifying AntiRheumatic Drug Therapy for Rheumatoid Arthritis – The percentage of members who were diagnosed with rheumatoid arthritis and who were dispensed at least one ambulatory prescription for a disease-modifying antirheumatic drug (DMARD).
Further reading
Antidepressant Medication Management – The percentage of members 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression and who remained on an antidepressant medication treatment. Two rates are reported.
• Effective Acute Phase Treatment. The percentage of members who remained on an antidepressant medication for at least 84 days (12 weeks).
• Effective Continuation Phase Treatment. The percentage of members who remained on an antidepressant medication for at least 180 days (6 months).
Further reading
Adult BMI Assessment – The percentage of members 18–74 years of age who had an outpatient visit and whose body mass index (BMI) was documented during the measurement year or the year prior to the measurement year.
Further reading
We covered the recent Medicaid news with Jerry Dubberly w/ Myers and Stauffer, Joel Menges w/ The Menges Group and Barb Witte.
We talked to Medicaid and political expert, Alexander Shekhdar about the impacts of the current Senate bill on Medicaid.
Avoidance of Antibiotic Treatment for Adults with Acute Bronchitis – The percentage of adults 18–64 years of age with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription. The measure is reported as an inverted rate [1 – (numerator/eligible population)]. A higher rate indicates appropriate treatment of adults with acute bronchitis (i.e., the proportion for whom antibiotics were not prescribed).
Further reading
Substance Abuse Mental Health Services Administration – HHS OPDIV which manages substance abuse and mental health programs.
Further reading
