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Get the free MCO External Quality Review Annual Technical Reports - dhcf dc

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District of Columbia Department of Health Care FinanceDistrict of Columbia Medicaid Managed Care Programs 2023 Annual Technical ReportSubmitted by Qlarant April 2024District of Columbia Managed Care
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MCO external quality review is a process where independent reviewers assess the quality of services provided by Managed Care Organizations (MCOs) to ensure they meet established standards and regulations.
Managed Care Organizations (MCOs) that provide healthcare services under state Medicaid programs are required to file MCO external quality reviews.
To fill out the MCO external quality review, organizations need to follow the specific guidelines provided by the state Medicaid agency, which typically involves submitting a detailed report of services rendered and quality metrics.
The purpose of MCO external quality review is to ensure accountability and quality of care provided by MCOs, assess their performance, and identify areas for improvement in service delivery.
Information that must be reported includes quality measures data, enrollment information, service utilization rates, and outcomes of care provided to the members.
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