Mississippi Division of Medicaid

This strategic plan outlines the Mississippi Division of Medicaid's Managed Care Quality Strategy for 2019-2023. It aims to improve access to necessary medical services, enhance the quality of care and population health, and increase efficiencies and cost-effectiveness through its coordinated care program, MississippiCAN. The strategy functions as a roadmap for continuous quality improvement, focusing on clinical quality, data analysis, regulatory adherence, and improved coordination of care to ensure positive health outcomes for vulnerable Mississippians.

This Managed Care Quality Strategy by the Mississippi Division of Medicaid outlines a roadmap for improving access to medical services, enhancing the quality of care, and improving cost predictability within its MississippiCAN and MississippiCHIP programs. It establishes a framework for continuous quality assessment, performance improvement, and accountability for Coordinated Care Organizations (CCOs). The strategy prioritizes preventive health care, healthy mothers, and healthy children, ensuring oversight through data collection, reporting, and adherence to federal and state regulations to achieve positive health outcomes for beneficiaries.

The Managed Care Quality Strategy for the Mississippi Division of Medicaid outlines its commitment to continuous improvement in care quality and responsible access to health coverage for vulnerable Mississippians. The strategy details the state's approach to monitoring, evaluating, and enhancing the managed care system through defined goals, objectives, and quality standards. Key focus areas include addressing health disparities, ensuring access to Long Term Services and Supports, implementing Performance Improvement Projects, and strengthening care coordination and integration. The plan emphasizes rigorous performance reporting, external quality review oversight, and robust access and transition of care policies, all designed to drive effective improvements in care quality, patient safety, and health outcomes.

This document outlines the proposed parameters for the Mississippi Hospital Access Program (MHAP) for State Fiscal Year 2027, beginning July 1, 2026. It details the allocation of $1,540,423,694 between the Fee Schedule Adjustment (FSA) and Quality Incentive Payment Program (QIPP), with specific provisions for the Health Information Network (HIN) and a Value Based Payment (VBP) pool. The plan addresses funding mechanisms to preserve MHAP funds, clarifies forfeiture risks based on quality metrics (PPHR, PPC, AM-PPC, POA reporting), and describes evaluation strategies to measure success in improving access to quality healthcare services.

This document is a summary of the strategic action plan developed by the MDMH Olmstead Policy Academy. It outlines the key strategic initiatives and actions planned by the academy.