Investor Presentaiton
Statewide Medicaid Performance on the ACO
Core Measure Set
For 2021, the AE Common Measure Slate did not include Colorectal Cancer Screening,
therefore Medicaid performance could only be reported on eight of the nine ACO
Core Measures. Rhode Island exceeded the national 75th percentile for the Medicaid
market on five measures and exceeded the national 90th percentile on one of the
measures (see Table 4.2). Medicaid performance was better for the chronic illness and
behavioral health measures than the preventative care measures (with the exception
of Developmental Screening in the First Three Years of Life). Although the national
benchmarks were higher for the Medicaid market than for the commercial market for
some measures, Rhode Island's overall performance relative to national benchmarks
on the ACO Core Measures was poorer for the Medicaid market than the commercial
market, suggesting greater inequity between the two markets in Rhode Island than
in other states.
Table 4.2. Statewide Medicaid Performance on ACO Core Measure Set
Measure
Breast Cancer Screening
Colorectal Cancer Screening
Comprehensive Diabetes Care: Eye Exam
National Benchmarks
75TH PCTL
90TH PCTL
Statewide Performance
ABOVE 75TH
ABOVE 90TH
PCTL?
PCTL?
57%
61%
Yes
No
60%
60%
ΝΑ
ΝΑ
NA
ΝΑ
57%
64%
Yes
No
63%
63%
Comprehensive Diabetes Care: HbA1c Control (<8.0%)
54%
58%
Yes
No
54%
54%
Developmental Screening in the First Three Years of Life
57%
65%
Yes
Yes
79%
79%
Follow-Up After Hospitalization for Mental Illness (7-Day)
46%
55%
Yes
No
54%
54%
Weight Assessment and Counseling - BMI percentile
84%
86%
No
No
83%
83%
Weight Assessment and Counseling - Counseling for Nutrition
81%
84%
No
No
76%
76%
Weight Assessment and Counseling - Counseling for Physical
Activity
78%
81%
No
No
74%
74%
Source: OHIC analysis of quality performance data of Rhode Island Medicaid managed care organizations obtained from EOHHS. Medicaid performance represents the full
population for the measure because EOHHS requires that insurers submit performance for their full population.
Annual Report: Health Care Spending and Quality in Rhode Island
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