Performance Measure

Agency Department of Medical Assistance Services (602) All measures for this agency • Increase the number of providers enrolled in the Medicaid and FAMIS programs [602.0005] • Percentage of children receiving dental services [602.0006] • Number of public meetings to communicate with and gain input from outside stakeholders [602.0007] • Number of Medicaid/FAMIS (Family Access to Medical Insurance Security Plan) enrolled children who received at least one dental service [60245609.002.001] • Percentage of expenditures for acute/medical services paid via capitated payments versus fee-for-service claims [60245609.003.001] • Percentage of agency’s discretionary contracting and purchasing through SWaM (Small, Women-owned, and Minority) vendors [60249900.007.001] • Percentage of two year olds in managed care who are fully immunized [M602SA12001] • Percentage of clients served through a capitated care program for coverage of their acute/medical services [M602SA12002] • Approval of 1115 COMPASS Waiver and related authorities by the CMS [602.0013] • Percentage of Budget Carry Forward [602.0015] • Percentage of level of care reviews on all current eligible waiver recipients [M602SA12023] • Percentage of accurate reimbursement payments processed within 30 calendar days of receipt of clean claim at the Department of Medical Assistance Services (DMAS) [M602SA12025] • Percentage of children's mental health expenditures for high intensity services [M602SA12026] • Percentage of all Client appeal decisions issued in full compliance [M602SA12027] • Percentage of members in managed care with cardiovascular disease who have blood presure controlled at less than 140/90 [60245609.004.001] • Percentage of individuals eligible for ICF/MR (Intermediate Care Facilities/Mental Retardation) placement who are served in the community [60245610.001.001] • Percentage of individuals eligible for nursing facility (NF) placement who are served in the community [60245610.002.001] • Percent of available funds expended [60246403.001.001] • Percentage of accurate reimbursement payments processed within 30 calendar days of receipt of clean claim at the Department of Medical Assistance Services (DMAS) [60232107.001.001] • The number of Quality Management Reviews on recipients completed each year [M602SA12007] • Percent of clean claims paid in 30 days [M602SA12024] • Percentage accuracy of agency budget forecast [602.0017] • Percentage of accurate reimbursement payments to eligible Electronic Health Record (EHR) Incentive program participants processed within 45 days of approved application [60240703.001.001] • Percentage of long-term care recipients who are served in the community [M602SA12030] • Number of individuals completing mandatory LTSS online training and certification [602.0009] • Number of Opioid Use Disorder (OUD) related emergency department visits [602.0011] • Number of pregnant women enrolled in Medicaid with a substance use disorder (SUD) who are engaged in SUD treatment at delivery [602.0014] • Number of individuals enrolled in the Medicaid Expansion population [602.0001] • Number of individuals accessing coordinated care through their managed care organization [602.0003] • Number of individuals residing in institutional settings [602.0004] • Number of individuals receiving services through the Addition and Recovery Treatment Services (ARTS) Program [602.0002] • Healthy Birthday Virginia [602.0018] • Percentage of children receiving immunizations [602.0010] • Increase healthcare utilization by Medicaid expansion population [602.0012] • Percentage of pregnant women in managed care who receive timely prenatal care [M602SA12028] • Number of long-term care recipients who are moved from fee-for-service into managed care [M602SA12029] • Number of unresolved state audit findings [602.0008] • Percentage of weekly remittance expenditures paid via Electronic Funds Transfer (EFT) [M602SA12018] • Proportion of Provider Helpline calls answered within 120 seconds [M602SA12019] • Proportion of Member Helpline calls answered within 120 seconds [M602SA12020] • The number of provider reviews completed each year [M602SA12021] • Percentage of FAMIS (Family Access to Medical Insurance Security Plan) Helpline calls answered within 90 seconds [M602SA12022] • Number of Administrative and Medical Deferrals and Disallowances [602.0016] • Percent of completed applications processed within 45 days [60246405.001.001] • Percentage of adolescents in managed care with at least one comprehensive well-visit per year [60246601.002.001] • The number of recipient reviews completed each year [M602SA12006] • Employee turnover rate [60249900.002.001] • Unit cost of processing Medicaid claims [60249900.006.002] • Percentage of claims submitted electronically [60249900.006.003] • Percent of total Medicaid expenditures paid via capitated PMPM (Per Member Per Month) or otherwise actively managed [M602SA12003] • Number of individuals transitioned into the community through the Money Follows the Person program [M602SA12004] • Percentage of all Provider appeal decisions issued in full compliance [M602SA12005] • Percent of providers who respond 'satisfied' or 'very satisfied' with Provider Enrollment Services [M602SA12008] • Percent Compliance of Breach Notifications for Unsecured Protected Health Information [M602SA12014] • Percentage of the number of weekly remittance payments processed via Electronic Funds Transfer (EFT) [M602SA12016] • Passing Score of Agency Capability Assessment for Readiness [M602SA12017]

Measure Name Increase the number of providers enrolled in the Medicaid and FAMIS programs

Measure Last Modified Jun 05 2019 10:11 Measure Last Published Sep 04 2019 03:41 Measure Status Retired Data Source and Calculation DMAS shall obtain this data from its Medicaid Enterprise System. Enterprise Priorities and Strategies Enterprise Initiative Enterprise Priority Enterprise Strategy StandIn X Associated Service Areas SA Code SA Name StandIn X

Measure ID 602.0005 Measure Class Agency Key Measure Type Outcome Year Type State FY Preferred Trend Increase Frequency Annually Statistical Unit

Baseline and Targets Target Name Date Result Note Baseline Short Target 2020 Long Target 2022 StandIn X

Measure Results Year Result Explanatory Note 2018 2019 StandIn X

- Run Date: 09/15/2021 03:00:50