Quality Assurance Subcommittee Focus 2005

Where Are We Now – 2004 in Review

ü      Pediatric Obesity:  Pediatric Obesity recommendation to MMCC, approved Sept. 2004.  HUSKY A & B working group, provider/consumer information matrix on covered services; next look at prevalence in HUSKY, clinical evaluation guidelines.

ü      Adolescent preventive health: report & recommendations that included DSS/MCO contract language.  Participation in DSS work group on revising the Medicaid EPSDT forms, anticipatory guidance items.

ü      Lead poisoning:  DPH matching process, LAMPP and Healthy Homes programs through SC presentation.  Sen. Harp recommended to DSS (December 2004) that recent lead match initially focus on Hartford data.

ü      Focus on adult health in HUSKY as well as children:

o       Report on ED visits by age, gender, top diagnoses.  DSS will ask Mercer to do this.  DSS & MCOs will focus on asthma-related ED visits, MCO assessment and action plans.

o       Report on Hospital admissions by age, gender, “top diagnoses”. Action?

ü      Asthma quality:  annual report on percentage of children aged 5-19 years and adults in HUSKY A with persistent asthma who received appropriate medications to control their asthma.  Is it possible to cross walk this with hospital, ED use?

Where Will We Go – 2005 Focus

Possible topics raised in MMCC

·        Pregnancy:  systematically identifying pregnant women’s needs/risks, collaboration MCO/Community providers.

·        Dental services, children, adults, pregnant women

 File: QA SC focus 2005