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External Quality Review

CCME provides External Quality Review (EQR) services for states that contract with Medicaid Managed Care Organizations (MCOs) or Prepaid Inpatient Health Plans (PIHPs).

We have provided EQR services in North Carolina, South Carolina, and Mississippi, which include:

  • Comprehensive review of the health plans’ compliance with state and federal requirements
  • Information systems capability assessment
  • Readiness reviews for new health plans
  • Performance measures validation
  • Performance improvement projects validation
  • 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

Our success in EQR stands on a record of completing all deliverables accurately and 100 percent on-time, every time. As a multistate EQR vendor, we apply broad, insightful expertise to ensure Medicaid recipients receive high-quality, accessible, and timely care services. For more information, contact:

Sandi Owens, LPN
Manager, External Quality Review