Summary

M. Davis and Company, Inc. is a subcontractor for HSAG’s External Quality Review Organization (EQRO) projects in Illinois, Ohio and Virginia. HSAG has the largest EQRO in the nation, affecting more than 33 million Medicaid recipients, or approximately 46 percent of the nation’s Medicaid population.

Process

M. Davis and Company, Inc. is responsible for:

• Providing registered nurses and case workers with on-site record reviews in multiple states, for the Medicaid and Medicare members they serve.
• Quality oversight along with contract administration and oversight for the Consumer Assessment of Healthcare Providers and Systems (CAHPS® ) Survey.
• Facilitating training, scheduling and logistic support for field review team operations.
• Performing monitoring by telephone to assess individual interview performance and quality checks of the seed mailings, to assess the sample administration, survey notification, and survey distribution processes.
• Providing medical record procurement oversight to ensure that medical record requests for both quantitative and qualitative information are handled appropriately and in a timely manner.

Results

MDAC is helping HSAG to fulfill its mandate as required by the code of federal regulations 42 CFR Part 438, Subpart E1, as the EQRO aggregates information on the timeliness, access, and quality of healthcare services furnished to Medicaid enrollees.