Members were 66 years of age or older as Reporting not Met Met Met Met Met of December 31 of the measurement year. required - small denominator Geographic Area Includes only Medicaid enrollees Reporting not Met Met Met Met Met served in the SCO’s reporting area. required - small denominator NUMERATORS Administrative Data: Counting Clinical Events Standard codes listed in state Reporting not Met Met Met Met Met specifications or properly mapped required - internally developed codes were used. small denominator Data sources used to calculate the Reporting not Met Met Met Met Met numerators (e.g., claims files, medical required - records, provider files, and pharmacy small records, including those for members who denominator received the services outside the plan’s network, as well as any supplemental data sources) were complete and accurate. Members had evidence of advanced care Reporting not Met Met Met Met Met planning as documented through either required - administrative data or medical record review. denominator Data Quality Based on the IS assessment findings, the Reporting not Met Met Met Met Met data sources used were accurate. required - small denominator Appropriate and complete measurement Reporting not Met Met Met Met Met plans and programming specifications exist required - that include data sources, programming small logic, and computer source code. denominator Proper Exclusion Methodology in Administrative Data (if no exclusions were mark as N/A) There are no exclusions for this measure. Reporting not Met Met Met Met Met required - small denominator Medical Record Review Documentation Standards
Members were 66 years of age or older as of December 31 of the measurement year. Reporting not required - small denominator Met Met Met Met Met Geographic Area Includes only Medicaid enrollees served in the SCO’s reporting area. Reporting not required - small denominator Met Met Met Met Met NUMERATORS Administrative Data: Counting Clinical Events Standard codes listed in state specifications or properly mapped internally developed codes were used. Reporting not required - small denominator Met Met Met Met Met Data sources used to calculate the numerators (e.g., claims files, medical records, provider files, and pharmacy records, including those for members who received the services outside the plan’s network, as well as any supplemental data sources) were complete and accurate. Reporting not required - small denominator Met Met Met Met Met Members had evidence of advanced care planning as documented through either administrative data or medical record review. Reporting not required - denominator Met Met Met Met Met Data Quality Based on the IS assessment findings, the data sources used were accurate. Reporting not required - small denominator Met Met Met Met Met Appropriate and complete measurement plans and programming specifications exist that include data sources, programming logic, and computer source code. Reporting not required - small denominator Met Met Met Met Met Proper Exclusion Methodology in Administrative Data (if no exclusions were mark as N/A) There are no exclusions for this measure. Reporting not required - small denominator Met Met Met Met Met Medical Record Review Documentation Standards
2017-sco-eqr-technical-report.docx