Claims data in addition to encounter data and cost reports from managed care organizations.
NY calculates HEDIS measures with claims data and generates Home Care Quality Indicators from its UAS-NY system for the elderly and physically disabled populations. NY also calculates the Phase I Behavioral Health Organization Metrics for the mental health population and uses various instruments for the DD population, including the National Core Indicators (NCI), the Restrictive Interventions Application (RIA), Incident Report and Management Application (IRMA), and the Health Home Care Management Assessment Reporting Tool (HHCMART).
NY will use assessment data from the interRAI CMH and the UAS-NY system to cover all community LTSS populations with the exception of the ID/DD population. NY evaluates outcomes and satisfaction for the ID/DD population with the New York Employment System, the National Core Indicators (NCI), the Office for People with Developmental Disabilities (OPWDD) Tracking and Billing System, and the eMedNY Medicaid tracking system. The MFP Quality of Life Survey covers individuals enrolled in MFP. Finally, three surveys will be used for individuals moving to managed care: Behavioral Health Supplemental Survey, Member Transition Survey, and the Consumer Assessment of Healthcare Providers and Systems (CAHPS).
NY is using Program funds to increase community capacity and encourage community placement; adjust provider rates for supported employment programs, Family Care services, and rehabilitative services in community residences; support strucutral changes; and create an Innovation Fund designed to engage NY's broad network of providers, advocates, and community leaders in developing systemic improvements that address barriers encountrered when providing community LTSS across all populations of Medicaid beneficiaries.