Network Adequacy Assessments and Reporting Implementation

Client: California Department of Managed Health Care (DMHC)

Mission Analytics is supporting DMHC in monitoring Medicaid managed care plans as part of the California’s 1115 waiver, which requires the automatic enrollment of seniors and persons with disabilities (SPDs) into managed care plans in 16 counties. Mission Analytics provides DMCH with quarterly assessments of access to providers for SPDs in 37 separate networks across the participating counties. To create these assessments, Mission Analytics processes provider lists submitted by the networks in order to calculate various measures of access to primary care physicians and specialists. Mission Analytics also advised DMHC in the development of standardized reporting template for provider networks, and is developing an analytical template using Quest Analytics, a software suite that geocodes beneficiary and provider locations for the purpose of calculating measures of geographic access.