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Measuring Managed Care Performance

National Committee for Quality Assurance Health Plan Ratings

Follow the link below to view the most recent ratings of MississippiCAN’s coordinated care organizations (CCOs) published by the National Committee for Quality Assurance. Due to COVID-19, the NCQA will not publish 2020 ratings, although plans are still required to submit that data to NCQA.

FFY 2019 Child and Adult Core Sets Measure Trend Snapshot

Published by the Centers for Medicare and Medicaid Services (CMS), the Federal Fiscal Year (FFY) 2019 Child and Adult Core Sets Measure Trend Snapshot display’s states’ performance on the frequently reported measures in the Child and Adult Core Sets for FFY 2015 through FFY 2019. The tables also show how Mississippi’s performance compares to performance reported by other states for each reporting year and highlights trends in performance over time. The tables reflect data reported by the Mississippi Division of Medicaid to CMS as of May 31, 2020.

Managed Care Value-Based Withhold Program

In state fiscal year (SFY) 2020, the Mississippi Division of Medicaid (DOM) implemented a Managed Care Value-Based Withhold on MississippiCAN capitation rate payments. This quality withhold is based on established quality metrics, such as Healthcare Effectiveness Data and Information Set (HEDIS) scores, which are already being reported by the CCOs.

DOM set a 1% withhold of capitation rates for SFY 2020.

Managed Care Liquidated Damages

The following table shows all managed care liquidated damages assessed by the Mississippi Division of Medicaid since January 2018.