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Medicaid Business Intelligence

This unit performs statistical analyses to evaluate the Statewide Medicaid Managed Care program, and communicates results to stakeholders and the public via publication of the Quarterly Statewide Medicaid Managed Care Report.  The unit will play a key role in answering the question: “What are we getting for our money?”

Unit Responsibilities include:

  • Monitors, evaluates, and reports on plan performance for the Statewide Medicaid Managed Care program. 
  • Analyzes enrollment, claims, and encounter data. 
  • Assesses the cost effectiveness of the SMMC program.
  • Evaluates the quality of provider networks.
  • Analyzes potentially preventable health care events.
  • Develops economic and statistical models to measure healthcare quality and costs.  
  • Develops metrics and benchmarks for healthcare analyses.
  • Reviews and implements current predictive models and statistical tools for health risk-based analyses and analyses of health plan performance.
  • Publishes the Quarterly Statewide Medicaid Managed Care Report.

Quarterly Reports