Nebraska Medicaid Program

Medicaid Medical Home Pilot
Outcomes and Measures

Outcome: Improve Health Care Access


  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


  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


  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


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

Provider Satisfaction


  1. Provider satisfaction