Quality in Managed Long-Term Services and Supports Programs. IV. Monitoring and Improvement Activities


All of the programs we examined rely on a variety of mechanisms to assess quality of care and MCO compliance with contract requirements for delivering services and supports. In this section we focus on audits, MCO reporting, verification of service receipt, mortality reviews, member feedback, how members participate in quality oversight, the EQRO's contributions to monitoring and improvement activities, the role of PIPs, how states use monetary incentives and penalties to reinforce quality objectives, and the use of MLTSS report cards.

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