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Performance Measurement & Quality Review

Rachel La Croix
AHC Administrator

Performance Measurement & Quality Review Unit

Phone: (850) 412-4670

Rachel La Croix, PhD
  • Establishes performance benchmarks for Medicaid managed care plans and analyzes results
  • Leads managed care quality improvements
  • Monitors specific programs for improvement opportunities
  • Produces the Medicaid Health Plan Report Card comparing Medicaid Managed Medical Assistance (MMA) plans

Medicaid Quality Activities and Projects

Florida Medicaid is committed to ensuring that health care services delivered through managed care plans are held to high standards of quality and excellence. All vendors contracted with the Agency to provide managed care services must meet specific requirements for ensuring quality both in services provided and in administrative processes involved in oversight of the plan's operations. Examples of activities and projects include the following:
  • Performance Measure Data Submissions for Medicaid
  • Florida Medicaid Draft Comprehensive Quality Strategy (2014 Update)
  • External Quality Review
  • Medicaid Health Plan Report Card

Florida Payment Error Rate Measurement (PERM)

Florida is one of 17 States in a three-year cycle randomly selected by the Centers for Medicare and Medicaid Services (CMS) for the Payment Error Rate Measurement (PERM) initiative for Federal fiscal year (FFY) 2017 (October 1, 2016 - September 30, 2017). This will be Florida’s fourth time participating in the PERM initiative.  (The three previous cycle measurements were in FFY 2008, FFY 2011, and FFY 2014.) For FFY 2017, CMS will measure Medicaid fee-for-service (FFS) claim payments, managed care capitation and premium payments made on behalf of beneficiaries.  CMS PERM will also continue to conduct its fifth round of the 50-state Medicaid and Children’s Health Insurance Program (CHIP) Eligibility Review Pilot targeted measurements.  (Previous Rounds of the Pilot targeted measurements occurring between FFY 2014-2016).