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Office of Quality Assurance and Improvement

The Office of Quality Assurance and Improvement (OQAI) supports and strengthens the Department of Health and Human Services (DHHS) mission through data driven analysis of DHHS activities and operations. OQAI responds to internal and external inquiries about programs, grants and other DHHS initiatives. The OQAI monitors performance improvement projects and supports compliance with regulatory and contract requirements. Data and reports are synthesized and disseminated to DHHS leadership, policy makers and the public via web postings and upon request, in an effort to provide assurances of good public stewardship and find opportunities for improvement.

Current major OQAI activities include:

  • The Medicaid Care Management (MCM) Program
    OQAI provides monitoring for assurance and improvement of the MCM program. NH OQAI MCM oversight is exemplary in its comprehensiveness and public reporting and has served as a model for other state Medicaid programs.
  • The Community Mental Health Agreement (CMHA)
    Section VII.C. of the CMHA includes the development of a quality system to address behavioral health issues driven by extensive data collection through a Quality Service Review (QSR). The NH QSR process was developed by OQAI and involves the use of multiple assessment tools to gather qualitative and quantitative data focused primarily on the CMHA priority service areas of assertive community treatment, employment support services, crisis services, housing, and transition planning. Additionally, OQAI produces a general quarterly data report for the CHMA including use of CMHC services, staffing, census and more.
  • Delivery System Reform Incentive Payment (DSRIP) Program
    The goal of the NH DSRIP demonstration is to support the development and implementation of an integrated care delivery system (IDNs) to improve the physical and behavioral health of Medicaid beneficiaries and reduce the costs of care. OQAI developed performance measures based on project milestones and metrics to track project planning, implementation progress, clinical quality and utilization indicators, progress toward transition to an Alternative Payment Models (APMs), and to validate IDN performance for incentive payments. Additionally, DSRIP requires a third party evaluation to ensure the demonstration achieves its intended goals and objectives. OQAI designed and oversees the assessment of DSRIP program evaluation and budget neutrality.
  • Premium Assistance Program (PAP) Evaluation
    The PAP program allows new Medicaid enrollees to find health care coverage on the health care marketplace. OQAI designed the CMS required PAP program evaluation and oversees the assessment of program outcomes and budget neutrality.
  • Medicaid Quality Information System (MQIS)
    OQAI is dedicated to transparency and public reporting. The MQIS system was designed and is maintained by OQAI for easy-to-find and use, web-based reporting. Individual clinical, experience of care and operational measures can be found on the MQIS website.
  • Medicaid Quality Reporting System (QRS)
    UNDER DEVELOPMENT! OQAI is actively engaged in developing Quality Rating System that will allow consumers to quickly compare the Medicaid managed care plans on the quality of their programs. OQAI anticipates rolling out the NH Medicaid QRS in 2017.

 

 
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New Hampshire Department of Health and Human Services
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