Senior Resources MI Choice Waiver program quality is recognized
Annual MI Choice Quality Withhold
Annually, 1% of all capitation payments are withheld by the Michigan Department of Health and Human Services (MDHHS) from MI Choice Waiver Agents to initiate quality improvement efforts within the program. Waiver agents have the ability to earn between 50% and 150% of the withhold. Waiver agents are ranked on the following criteria:
- Encounter Data
- Significant Support Participant Count
- Acuity Levels of Participants
- Clinical Quality Assurance Review Ranking
- Timely reports to MDHHS
We are honored to announce, for fiscal years 2018 and 2019, the extreme attention to detail, hard work and team-based efforts of the Senior Resources Data Department earned the number 1 ranking out of 20 Waiver Agents in the state of Michigan. The Data Department exceeded expectations regarding timely and accurate submissions of encounter data. Overall, Senior Resources received 90% of the quality withhold for FY 2019.
"Everybody plays a role in that," said Stacy Strauss, Managed Care Operations manager said. "It's very important work."
Clinical Quality Assurance Review
Annually, the MI Choice Waiver program receives a clinical audit in which participant records are reviewed to assure compliance with all contract standards and to assure participants needs are met. We are proud to announce the MI Choice Waiver program received an overall compliance level of 3.98 out of 4.00.
The compliance level shows that Senior Resources substantially meets assurances. As we continue moving forward, we are focusing on communication from our provider network as our lowest score was based on the providers' failure to inform us if the participant experienced a health and welfare issue.
