The Community Care of North Carolina (CCNC) networks are collaboratively and individually developing quality improvement (QI) and care management initiatives that achieve access, quality, utilization, and cost objectives by improving the management of patient care. These initiatives aim to assess the needs and severity of their Medicaid populations in order to target care and disease management activities. The successful implementation of the care management processes will help networks better manage their Medicaid populations and improve healthcare outcomes.
Performance measures and benchmarks for the program-wide QI initiatives are identified by the Clinical Directors to evaluate the performance of individual practices and the local network. Typically, outcome data include hospital admissions or use of the emergency room, while process measures may include periodic assessments or treatment plans recorded in the medical records. The data are collected through claims databases and regular chart reviews.