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Quality

Section 2602 of the Affordable Care Act charges the Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office, or MMCO) with improving the quality of health and long-term care services for Medicare-Medicaid enrollees as well as improving the quality of performance of providers of services and suppliers under Medicare and Medicaid.  

The ultimate goal of MMCO’s quality strategy is achieving better outcomes and quality of life for Medicare-Medicaid enrollees. Quality measurement is one critical component of MMCO’s overall efforts to improve quality for Medicare-Medicaid enrollees.  Quality measurement is an effective tool to enhance knowledge about the population as well as accountability for providers and programs.  It is most effective when used as an integral part of policy analysis, evaluation, program development, stakeholder engagement, and quality improvement efforts.

Specifically, MMCO has developed a multi-faceted quality approach to achieve these aims and underlies all of MMCO’s efforts to better align Medicare and Medicaid for individuals receiving benefits through both programs.  The strategy informed by the work of experts, consensus-based organizations, and other stakeholders.  For example, recommendations from the multi-stakeholder panel convened by The National Quality Forum (NQF), including the core measure set outlined in its June 2012 report Measuring Healthcare Quality for the Dual Eligible Beneficiary Population, helped establish the framework and roadmap for the Centers for Medicare and Medicaid Services (CMS) in moving forward in measure stratification and development for Medicare-Medicaid enrollees.  The Office’s work is also consistent with the Department’s National Quality Strategy and the CMS Quality Framework, including measures that support the domain priorities identified in both.  Furthermore, it maintains measure and reporting consistency by looking across programs to coordinate measures like the Medicaid Adult Core and HEDIS.  MMCO strives to incorporate information from quality measurement analysis into the development of its key initiatives.