External Quality

Don’t just meet your quality goals — exceed them

As an External Quality Review Organization (EQRO), Acentra Health monitors the quality of programs and services provided by your managed care partners. Our team of medical and technical experts analyze volumes of data to identify opportunities to improve the timeliness, quality, and access to care.

We deploy an integrated team of medical and technical experts who analyze data, identifying issues related to timeliness, quality, and access to care. This process reveals the nuances of program performance, including its impact on population health. For example, we provide valuable, actionable feedback to plans about their PIP (performance improvement projects) programs, including an evaluation of project design, validation measures, and interventions.

As a result of our comprehensive model, states can meet EQRO requirements while ensuring that members are receiving the highest-quality, most efficient, and appropriate care.

Acentra Health is committed to helping
Medicaid agencies achieve

Stethoscope

Improved health outcomes

Respect

Accessible, coordinated, 
high-quality care

Experience

Increased member satisfaction

Robust EQRO Capabilities

Information system capability assessments
Healthcare Effectiveness Data and Information Set (HEDIS) reviews and program analysis
Performance measure validation
Performance improvement plan development, implementation, and review
Ongoing training, education, and technical assistance during and after reviews
Medical education interventions for facilities, physicians, and other providers
Comprehensive data collection, analysis, and reporting
Continuous quality improvement and outcomes management
Robust EQRO Capabilities

Improve healthcare quality oversight with
our cross-functional solutions

Engagement
Appeals & Grievances

Reach successful conclusions with flexible processes that work for your organization's unique systems and criteria.

Action Report
Standard of Care Review

Promote continuous quality improvement through objective quality reviews.

CMS-Waiver
CMS Waiver Oversight

Achieve high-quality long-term services and supports with comprehensive Medicaid waiver oversight and accountability.

Get Started with Acentra Health

Connect with an expert from our team and learn more about how 
Acentra Health's solutions and services can benefit your organization.

Request a Demo
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