Gina Olivares

Oct 17, 20191 min

MLTC & Healthcare: Why are Quality Measures important? Managed Long Term Care (MLTC)

Updated: Jul 1, 2020

Many measures are considered in the calculation of Quality Incentives. As we know from the previous post, Quality Incentives are comprised of 4 areas: Quality Measures (QM), Satisfaction Measures (SM), Efficiency Measures (EM) and Compliance Measures (CM).

Quality Measures are especially important in Quality Incentives: the 9 QM constitute 45 points of 93 possible in total. The other 38 points are distributed between SM with 30 points, EM with 10 points and CM with 8 points.

QM not only represent 48% of all possible points, but the measures in this area are evaluated every semester, this means the results of this area change very often.

On the good side, the fact that the measurement periods for these 9 measures are closer together, allows us to have more data about the performance of plans over time. With more information available, more detailed analysis can be in order to implement actions and get better results.

And a bonus, 7 QM are also considered in the Star-Rating for MLTC plans (MLTC Consumer Guide), by improving these measures, you automatically improve the number of stars in some domains!

Let's work together to bring your plan to the next level in Quality Incentives and Star-Ratings.

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