Publications > Measuring Quality for Complex Medicaid Beneficiaries in New York

This new Medicaid Institute report points to the importance of quality measurement for Medicaid beneficiaries with complex needs — specifically those with multiple chronic conditions, behavioral health conditions, and long-term care needs — as a means of improving care but also as a tool to advance the state’s strategies of reimbursement reform and service delivery redesign for vulnerable and high-cost populations. 

Prioritizing what is being measured — and why — can have important consequences for both patients and the state’s purchasing decisions. Systemwide challenges that the “right” data can help address include assessing the effectiveness of transitions across health care settings and the coordination of care among primary care, acute care, and social services.

Having sound quality measurement data is at the heart of improving care, both at the level of individual beneficiaries and at the level of broader system changes, such as moving patients with complex needs from fragmented fee-for-service care to managed care and other care management models.

Measuring Quality for Medicaid Beneficiaries with Complex Needs in New York State was prepared for the Fund’s Medicaid Institute by Alice Lind, RN, MPH, of the Center for Health Care Strategies.

Read the related press release.