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    Office of Long-Term Living (OLTL)

    Bureau of Quality Assurance and Program Analytics

    The Bureau of Quality Assurance and Program Analytics is responsible for ensuring that valid statistical and procedural methodologies are used to collect and analyze quality control data to evaluate and improve service delivery and to ensure compliance with federal and state regulations. 

    The bureau manages data analysis to measure the effectiveness of program design and operations, and ensures required reports are provided to Centers of Medicare and Medicaid Services (CMS) and other regulatory entities, supports OLTL management in the development and implementation of policies and procedures, directs the development and implementation of internal and external training to improve service delivery, oversees the analysis of data obtained through consumer satisfaction surveys and provider performance measures and oversees internal and external activities of OLTL Monthly Quality and Quarterly Quality Review meetings reviewing waiver assurances. 

    Divisions

    The Division of Program Analytics extracts and analyzes Community HealthChoices (CHC) Managed Care Organization (MCO), fee –or-service (FFS), Living Independence for the Elderly (LIFE), and Medicare data to provide OLTL executive staff with reports of finding and trend analysis, and recommends process and program improvements based on these findings.  The division prepares a variety of ad hoc and regular reports. The division supports the External Quality Review Organization’s (EQRO) activities, including Healthcare Effectiveness Data and Information Set (HEDIS), Key Performance Measures (KPM), and Performance Improvement Projects (PIP). The division supports pay-for-performance (P4P), value-based purchasing (VBP), the Nursing Facility Quality Incentive, and the Long-Term Care Learning Network.  

    Responsibilities include development, implementation, and maintaining a quality management strategy and improvement system consistent with the CMS and Ddepartment quality framework model supporting OLTL programs. Division assignments and projects include: Clinical Medical Reviews, reporting and processing of OLTL’s Hhome and Ccommunity-Bbased Sservices (HCBS) programs quality projects;, quality improvement programs for all CMS 1915 (b) and 1915(c) federal and OLTL Programs;, reporting of CHC Services Complaints and Grievances and CHC Services Hearing and Appeals, and the Annual Participant Review Tool (PRT) and the Annual HCBS Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey tools. 

    Contact OLTL

    OLTL Participant Helpline

    1-800-757-5042

    Enrolled OLTL participants can call the helpline with any concerns regarding their services. Hours are Monday through Friday, 9 a.m-12 p.m. and 1-3 p.m.