MLTC Consumer Guide Domains

A Consumer's Guide to Managed Long-Term Care

The NYS Department of Health publishes six regional guides to Managed Long-Term Care in New York State.

The consumer guides rate health plans on four domains of care and five measures of consumer satisfaction. Plans are scored for each domain based on their standard score, and the overall rating represents the performance for the plan across domains.

The measures used in this guide represent some, but not all of the measures collected from health plans through the Uniform Assessment System for NY (UAS-NY). For measures included in this consumer guide, a higher rate is a better score. For additional information about the individual measures used in each category, as well as, the other quality of care measures available, please see the New York State Department of Health's website.

The following describes the measures in each domain of care:

Prevention

  • Flu Immunization Status: Percentage of members who received an influenza vaccination in the last year.
  • Pneumococcal Immunization Status: Percentage of members age 65 and older, who received a pneumococcal vaccination in the last five years or after age 65.
  • Dental Exam in the Last Year: Percentage of members who received a dental exam in the last year.
  • Eye Exam in the Last Year: Percentage of members who received an eye exam in the last year.
  • Hearing Exam in the Last Two Years: Percentage of members who received a hearing exam in the last two years.
  • Mammogram/Breast Exam in the Last Two Years Among Females 50-74 years old: Percentage of female members ages 50-74, who received a mammogram or breast exam in the last two years.

Patient Safety

  • No Falls Resulting in Medical Intervention: Risk-adjusted percentage of members who did not have falls that required medical intervention in the last 90 days.
  • No Emergency Room Use: Risk-adjusted percentage of members who did not have an emergency room visit in the last 90 days.

Advanced Directives

  • Talked About Appointing for Health Decisions: Percentage of members who responded that a health plan representative talked to them about appointing someone to make decisions about their health if they are unable to do so.

Quality of Life

  • No Shortness of Breath: Percentage of members who did not experience shortness of breath.
  • No Severe Daily Pain: Risk-adjusted percentage of members who did not experience severe or more intense pain daily.
  • Not Lonely and Distressed: Risk-adjusted percentage of members who were not lonely and did not experience any of the following: decline in social activities, eight or more hours alone during the day, major life stressors, self-reported depression, or withdrawal from activities.

Rating of Health Plan

  • Rating of Health Plan: Risk-adjusted percentage of members who rated their managed long-term care plan as good or excellent.

Rating of Regular Visiting Nurse

  • Rating of Regular Visiting Nurse: Risk-adjusted percentage of members who rated the quality of regular visiting nurse services within the last six months as good or excellent.

Rating of Care Manager

  • Rating of Care Manager: Risk-adjusted percentage of members who rated the quality of care manager/case manager services within the last six months as good or excellent.

Timeliness of Aide

  • Timeliness of Home Health Aide/Personal Care Aide: Risk-adjusted percentage of members who reported that within the last six months the home health aide/personal care aide services were always or usually on time.

Involved in Decisions

  • Involved in Decisions About Plan of Care: Risk-adjusted percentage of members who responded that they are usually or always involved in making decisions about their plan of care.

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