Common use of MCO REPORTS, SUBMISSIONS, AND TEMPLATES Clause in Contracts

MCO REPORTS, SUBMISSIONS, AND TEMPLATES. When requested, MCOs will report Quality Improvement Results using the QI Goals Submission Templates developed and distributed by EOHHS or its designee. QI Goal Reporting submissions shall include quantitative and qualitative data as well as specific progress made on each measure, barriers encountered, lessons learned, and planned next steps. For specific instructions on the submission process and detail on the submission templates, MCOs shall refer to guidance to be distributed by EOHHS or its designee. Reporting on the interventions should at a minimum include the following items (to be described with greater specificity in the forthcoming Submission Guide Document): • Rationale for selecting proposed/implemented interventions • Description of current interventions • Analysis of short-term indicators, HEDIS rates as applicable, data collection procedures and methodology, and interpretation of results • Assessment of intervention successes and challenges, and potential intervention modifications for future implementation periods. Evaluation of QI Reports: EOHHS or its designee will review QI Goal Reports using a standardized Evaluation Template. The scoring elements in the Evaluation Template will correspond directly with the elements documented on the reporting templates. Feedback will be provided to the MCOs for each implementation period.

MCO REPORTS, SUBMISSIONS, AND TEMPLATES. When requested, Participating MCOs will report submit to MassHealth or its designee: • One Quality Improvement Results Plan and one Annual Report during the Planning/Baseline Implementation period; • One Progress Report and one Annual Report during each re-measurement period. MCOs should refer to Table 1 (QI Goal Implementation Period and Associated Activities) for reporting timeframes. MCOs will submit Quality Improvement Plans and Reports using the QI Goals Submission Templates developed and distributed by EOHHS on or its designeebefore March 1, 2021. QI Goal Reporting submissions shall include quantitative and qualitative data as well as specific progress made on to each measure, barriers encountered, lessons learned, and planned next steps. For specific instructions on the submission process and detail on the submission templates, MCOs shall refer to guidance to be distributed by EOHHS on or its designeebefore March 1, 2021. Reporting on the interventions should at a minimum include the following items (to be described with greater specificity in the forthcoming Submission Guide Document): •  Rationale for selecting proposed/implemented interventions •  Description of current interventions •  Analysis of short-term indicators, HEDIS rates as applicable, data collection procedures and methodology, and interpretation of results •  Assessment of intervention successes and challenges, and potential intervention modifications for future implementation periods. Evaluation of QI Reports: EOHHS or its designee will review QI Goal Reports using a standardized Evaluation Template. The scoring elements in the Evaluation Template will correspond directly with the elements documented on the reporting templates. Feedback will be provided to the MCOs for each implementation period.

MCO REPORTS, SUBMISSIONS, AND TEMPLATES. When requested, MCOs will submit to MassHealth or its designee: • One Planning/Progress report and one Annual/End-of-Year Report during the CY22 Implementation period. MCOs should refer to Table 1 (QI Goal Implementation Period and Associated Activities) for reporting timeframes. MCOs will submit Quality Improvement Results Reports using the QI Goals Submission Templates developed and distributed by EOHHS or its designeedesignee on or before March 1, 2022. QI Goal Reporting submissions shall include quantitative and qualitative data as well as specific progress made on each measure, barriers encountered, lessons learned, and planned next steps. For specific instructions on the submission process and detail on the submission templates, MCOs shall refer to guidance to be distributed by EOHHS on or its designeebefore March 1, 2022. Reporting on the interventions should at a minimum include the following items (to be described with greater specificity in the forthcoming Submission Guide Document): • Rationale for selecting proposed/implemented interventions • Description of current interventions • Analysis of short-term indicators, HEDIS rates as applicable, data collection procedures and methodology, and interpretation of results • Assessment of intervention successes and challenges, and potential intervention modifications for future implementation periods. Evaluation of QI Reports: EOHHS or its designee will review QI Goal Reports using a standardized Evaluation Template. The scoring elements in the Evaluation Template will correspond directly with the elements documented on the reporting templates. Feedback will be provided to the MCOs for each implementation period.