OUTCOMES MEASUREMENT AND MANAGEMENT WITH A LARGE MEDICAID POPULATION - A PUBLIC-PRIVATE COLLABORATION

Recipients, consumer advocates and purchasers expect managed care comp anies, in partnership with their provider networks, to measure and to continuously improve quality of care. This task is especially challeng ing when the beneficiaries of that care are covered by a publicly fund ed program. Yet this will be an increasingly common occurrence as more states contract with managed care companies for the care management o f their Medicaid populations. In this article, the authors describe th e outcomes measurement and management program of the first statewide m anaged Medicaid behavioral health carve-out program. Much of the found ation of that program has been built through collaborative efforts bet ween the Massachusetts Division of Medical Assistance as purchaser, MH MA as managed care vendor, recipients, providers and other stakeholder s. The authors report on the FMH/MHMA experience and what they learned . The principles derived from this outcomes program may be helpful to other states and to managed care companies undertaking similar public/ private partnerships.