External Quality Review
CCME provides external quality review to ensure Medicaid recipients receive high-quality, accessible, and timely care. As a multi-state External Quality Review Organization (EQRO) we partner with state agencies and health plans to provide best practice solutions to improve system performance and patient care.
Solutions
Customized and Actionable
Working hand-in-hand with state agencies and the managed care organizations or health plans they contract with, we assess the quality, timeliness, and accessibility of the care and services delivered to the Medicaid members enrolled in each of the health plans. As a multistate External Quality Review Organization (EQRO), we're passionate about applying our knowledge, decades of combined experience and flexibility to identify gaps in system delivery and provide the tools necessary to take action. EQR services include:
- Comprehensive review of compliance with state and federal requirements
- Information systems capability assessment review
- Readiness reviews for new health plans
- Performance measures validation
- Performance improvement project validation
- Validation of network adequacy
- Consumer and provider satisfaction survey validation
- Ongoing training, education, and technical assistance for health plans
- Evaluation of state’s quality strategy
- Develop plans for quality improvement
Outcomes
24+
24+ Years Experience
A trusted partner, we have held the EQR contract with the South Carolina Department of Health and Human Services (SCDHHS) since 1996.
100%
100% On Time
We have performed 161 annual reviews, 18 readiness reviews and 74 telephone access studies with 100 percent completed on time.
Outcomes
24+
24+ Years Experience
A trusted partner, we have held the EQR contract with the South Carolina Department of Health and Human Services (SCDHHS) since 1996.
100%
100% On Time
We have performed 161 annual reviews, 18 readiness reviews and 74 telephone access studies with 100 percent completed on time.
Customers
Decades of Experience
We apply decades of combined experience in delivering EQR services in North Carolina, South Carolina and Mississippi.