Nebraska Medicaid Program

Medicaid Medical Home Pilot
Outcomes and Measures

Outcome: Improve Health Care Access

Measures:

  1. Routine source of health care
  2. Wait time to get an appointment (for both urgent and routine care)
  3. Patient perception of access to care

Outcome: Improve Health Outcomes for Patients

Measures:

  1. Days of work or school lost due to patient’s health condition
  2. Self-reported health status
  3. Readmission to a hospital within 30 days for the same complaint
  4. Readmission to an emergency room within 72 hours for the same complaint

Outcome: Contain Costs in the Medical Assistance (Medicaid) Program

Measures:

  1. Number of emergency room visits
  2. Expenditures for emergency room care vs. non-emergent care in the ER
  3. Number of inpatient hospital admissions for ambulatory care-sensitive conditions (ACSC)-COPD, CHF, Diabetes Mellitus, Pediatric Asthma
  4. Expenditures for inpatient hospital care for ACSCs- COPD, CHF, Diabetes Mellitus, Pediatric Asthma
  5. Number of specialty care visits
  6. Expenditures for specialty care
  7. Expenditures for high-tech radiology use
  8. Total expenditures per member per month
  9. Expenditures for prescribed drugs
  10. Percent of prescriptions for generic drugs

Patient Satisfaction

Measures:

  1. Patient/parent satisfaction
  2. Patient/parent perception of quality/coordination of care

Provider Satisfaction

Measures:

  1. Provider satisfaction