2018 Protocol review with CCOs

The HealthInsight Assure review team is preparing to conduct an external quality review (EQR) of the CCOs in 2018. The two areas we will be reviewing are:

• Quality Assessment and Performance Improvement (QA/PI)
• Information Systems Capability Assessment (ISCA)

HealthInsight Assure is responsible for reviewing the CCOs relative to compliance with the QA/PI CFRs referenced in the protocol. The compliance protocol includes the CFRs, scoring criteria, a list of suggested documents for the CCOs to submit, and the questions that help clarify how the CCO meets the scoring criteria.

Separately, HealthInsight Assure is responsible for performing an Information Systems Capability Assessment (ISCA) in accordance with CMS’ EQR Appendix V – Information Systems Capability Assessment protocol.  The ISCA protocol includes scoring criteria, a list of suggested documents for the CCOs to submit, and questions that address the scoring criteria. 

HealthInsight Assure is currently working with OHA to update both the ISCA and compliance protocols to include current CFRs (compliance only), OHA priorities, and CCO contract references, where appropriate. The next step in the process is to have the CCOs review the draft protocols and let us know where clarification is needed.

We will provide CCO representatives with the draft protocols prior to the meeting on November 30, 2017.  Feedback on the draft protocols should be limited to areas needing to be clarified in the scoring criteria, the documents to be submitted, and the questions.

Below is the November 30^th agenda:

• QA/PI protocol will be reviewed from 10 a.m. - noon
• ISCA protocol will be reviewed from 1 p.m. - 4 p.m.

After the meeting on November 30, HealthInsight Assure will incorporate the feedback and prepare final drafts that will be reviewed by OHA. The final OHA-approved protocols will be distributed to the CCOs prior to the 2018 EQR reviews.

Please register below and indicate which section you will be attending. Each CCO is limited to one representative for each section. A conference call-in number will be provided if others wish to listen to the discussion.