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On an annual basis, the Department of Health and Mental Hygiene evaluates Managed Care Organization quality. For CY 2010, Jai Medical Systems became the first Managed Care Organization in the history of the Maryland Medicaid program to achieve a perfect score by exceeding the incentive targets in all 10 Value Based Purchasing Initiative measures. Jai Medical Systems repeated this feat achieving 10 out of 10 Incentives in the Value Based Purchasing Initiative measures for CY 2012. Jai Medical Systems’ performance distinguishes the company not only in Maryland, but ranks the company among the best in the nation. In fact, Jai Medical Systems is the highest-rated Medicaid Health Plan in Maryland and one of the highest-rated Medicaid health plans in the nation with a rating of 4.5 out of 5 in NCQA’s Medicaid Health Insurance Plan Ratings 2015-2016*. In addition, Jai Medical Systems has received a rating of Excellent (the highest rating possible) for 2015/2016 from NCQA for our overall quality.
For more information on Jai Medical Systems’ quality initiatives, please check out our Quality Reports.
HEDIS Criteria
Access to HEDIS Criteria is available for our participating providers. Please contact our Quality Assurance Department if you require assistance in accessing our HEDIS Criteria.
- Overview of HEDIS Criteria
- Use of Spirometry Testing in the Assessment and Diagnosis
- Pharmacotherapy Management of COPD Exacerbation
- Use of Appropriate Medications for People with Asthma Measure
- Medication Management for People with Asthma
- Controlling High Blood Pressure
- Annual Monitoring for Patients on Persistent Medications
- Use of Imaging Studies for Low Back Pain
- Immunization Status Measure
- Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis
- Appropriate Testing for Children with Pharyngitis
- Appropriate Treatment for Children with Upper Respiratory Infection
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
- Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
- Cholesterol Management for Patients with Cardiovascular Conditions
- Prenatal and Postpartum Care and Frequency of Ongoing Prenatal Care
- Adult BMI Assessment
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
- Comprehensive Diabetes Care
- Well-Child Visits Measure
- Chlamydia Screening in Women
- Breast Cancer Screening
- Cervical Cancer Screening
- Access/Availability of Care
*National Committee for Quality Assurance (NCQA) is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS® is the most widely used performance measurement tool in health care. NCQA’s Web site (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.
Quality Reports
We strive to ensure our members have access to quality care.
To review our Managed Care Organization Quality Reports, check out the links below.
Consumer Report Card 2019
Member Satisfaction Survey Results
Executive Summary of Annual Report
Quality Assurance Program Description 2019
Jai Medical Systems ranked #1 for Quality