MLTC Consumer Guide Domains

A Consumer's Guide to Managed Long Term Care

The NYS Department of Health has published a consumer's guide to Managed Long Term Care in New York City

The Consumer Guide rates plans on seven domains of care and three measures of consumer satisfaction. Plans are scored for each domain based on their standard score, and ranked on overall performance in each domain.

The measures used in this guide represent some, but not all of the measures collected from health plans through the NYS Semi-Annual Assessment of Members (SAAM) Tool. 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:

Flu Prevention

  • Flu Immunization Status: Percentage of members who received an influenza vaccination in the past year.

Patient Safety

  • Falls Not Resulting in Medical Intervention: The risk-adjusted percentage of members who had falls that did not result in medical intervention in the past 6 months.
  • Oral Medication Management: The risk-adjusted percentage of members who are independently managing oral medication.
  • No Hospital Emergent Care: The risk-adjusted percentage of members who did not receive emergent care in the hospital.

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.

Activities of Daily Living

  • Ambulation: Percentage of members whose ability to safely walk or use a wheelchair on a variety of surfaces was stable or improved over the follow-up period.
  • Bathing: Percentage of members whose ability to wash their entire body was stable or improved over the follow-up period.
  • Transferring: Percentage of members whose ability to move from one location to another, such as from a bed to a chair, was stable or improved over the follow-up period.
  • Dressing Upper Body: Percentage of members whose ability to dress their upper body was stable or improved over the follow-up period.

Management of Incontinence

  • Urinary Incontinence/Catheter Presence: Percentage of members who remained stable or improved in presence of incontinence or catheter need over the follow-up period.
  • Urinary Incontinence Frequency: Percentage of members who remained stable or improved in frequency of urinary incontinence over the follow-up period.

Quality of Life

  • Frequency of pain: Percentage of members who remained stable or improved in frequency of pain.
  • Shortness of Breath: Percentage of members who remained stable or improved in experiencing shortness of breath over the follow-up period.
  • Depressive Feelings: Percentage of members who remained stable or improved in experiencing depressive feelings over the follow-up period.

No Known Emergency Care

  • No Known Hospital Emergent Care: The risk-adjusted percentage of members for whom no emergent care was reported during the follow-up period.

Rating of Health Plan

  • Rating of Health Plan: The 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: The risk-adjusted percentage of members who rated the quality of regular visiting nurse services or supplies within the last 6 months as good or excellent.

Rating of Care Manager

  • Rating of Care Manager: The risk-adjusted percentage of members who rated the quality of care manager/case manager services or supplies within the last 6 months as good or excellent.

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