Monday Morning Medicaid Must Reads: October 1st, 2018

Helping you consider differing viewpoints. Before it’s illegal. 


Article 1:  

Jersey Community Hospital receives Small and Rural Award for quality improvement,, 9/27/2018

Clay’s summary: Sometimes we forget that healthcare happens on the ground. Here’s an example of an IL hospital improving readmission rates.

Key Passage from the Article

Jersey Community Hospital’s all-cause readmission rate dropped from 16% to 7% with an estimated 63 readmissions prevented over a 12-month period and a total cost savings of $455,600.

“I’m happy that the high quality of care provided at JCH is being recognized for its consistency and reliability. I’m proud of the team here and they are deserving of this recognition” stated Jon Wade, CEO.

IHA President and CEO A.J. Wilhelmi recognized Jersey Community Hospital’s project team at the association’s annual Leadership Summit. Michael McNear, MD, Chief Medical Officer and Medical Group President, accepted the award on the team’s behalf.

IHA’s Institute for Innovations in Care and Quality spearheaded this effort to highlight the quality improvement work of IHA-member hospitals and health systems. The Institute is a strategic center actively engaged in implementing evidence-based quality and safety initiatives while creating innovative member programs to measurably strengthen the quality of healthcare across Illinois.


Read it here 

Article 2:   

NURSING HOME QUALITY: Continued Improvements Needed in CMS’s Data and Oversight, GAO, 9/6/2018

Clay’s summary: When was the last time you were in a nursing home? There is a wide spectrum of quality out there…

Key Passage from the Article

About 15,600 nursing homes participate in Medicare and Medicaid. To help ensure that residents receive quality care, the Centers for Medicare & Medicaid Services (CMS) collect data (such as nurse staffing levels) on these nursing homes.

We testified that CMS’s data showed mixed results—they showed an increase in consumer complaints along with improvements in the quality of care. We found that data issues (e.g., different states using different data collection methods) complicated CMS’s ability to assess whether the results reflected actual changes. We made recommendations to address these issues in the report on which this testimony is based.


Read it here 




Article 3:   

Amerigroup Ranked Among Top Medicaid Plans in Texas by NCQA, BusinessWire, 9/28/2018

Clay’s summary: It’s easy to forget that plans are staffed by people who care about people. They work hard to improve the quality of care delivered, and should get props when they do well. Yay, Amerigroup Texas!

Key Passage from the Article

“Amerigroup is pleased to be recognized by the NCQA as one of the highest performing Medicaid health plans in the state,” said Tisch Scott, plan president, Amerigroup Texas. “These ratings demonstrate that our consumers have timely access to care, and they’re receiving the right care at the right time. Quality is foundational to everything we do at Amerigroup, and we’re committed to building on our accomplishments to provide a better healthcare experience for all consumers.”

In recognizing Amerigroup, the NCQA evaluated the plan’s performance based on three areas — consumer satisfaction, prevention and treatment. Amerigroup received an overall score of 3.5 out of 5.


Read it here