Friday, February 7, 2014
Message from the Director:
I am pleased to present the District of Columbia’s Managed Care Quarterly Performance Report. This is the first ever performance report on the Medicaid and Alliance managed care programs which provide health insurance coverage to nearly 175,000 District residents at an investment of over $820 million District and federal dollars.
Prior to the development of this report, the District’s managed care program was never subject to a comprehensive performance evaluation. Through quarterly reports, which will culminate in an annual report card on the District’s managed care organizations (MCOs), DHCF will evaluate MCO performance across a number of domains including the health plans’ financial condition, administrative performance, care management outcomes, trends in beneficiary utilization, and the health plans’ related medical care spending.
The data utilized for this report are generally from the time period of July 2013 through September of 2013 and reflect the operation of the District’s managed program by three new providers – AmeriHealth DC, MedStar Family Choice, and Trusted Health Plan. Subsequent reports will be more comprehensive as the MCOs develop an operational history in the District that will allow the tracking of trends in the performance of the health plans over time.
The initial findings from this report are mixed and should be considered preliminary as the MCOs are in the early stages of the new contract period. While this report indicates that the plans are meeting key requirements for the managed care program, there are significant areas where improvement is warranted and will be closely monitored by DHCF.
It is my hope that the District’s Managed Care Quarterly Performance Report will inform agency decision making about the program and facilitate an open dialogue with our stakeholders in a manner that strengthens the quality of the Medicaid and Alliance managed care programs.
I look forward to sharing future reports on the performance of DHCF’s managed care program as is consistent with Mayor Vincent Gray’s commitment to an open and transparent government.