Quality Measurement and Reporting in California
California law outlines quality measurement and reporting requirements for health care providers as well as its Medicaid program, called Medi-Cal. Each Medi-Cal plan must take steps to monitor and evaluate the quality of care given by providers as well as improve the quality of care. Plans are required to implement a quality improvement plan, a system of accountability, objective and systematic monitoring and evaluation of the quality of clinical care and health care service delivery and a utilization management program.1 Additionally, the Department of Health Services must utilize the Management Information System in order to oversee and evaluate the quality of care given to Medicaid recipients and their access to services.2
Further quality measures in California include the reporting of physician malpractice settlements or judgments to the Medical Board. California requires reporting malpractice settlements or judgments when the amount is above $30,000 in certain circumstances.3 In addition, the Medical Board is authorized to release physician information related to provider quality to the public, upon request. Information that can be released includes a physician’s disciplinary actions, the issuance of temporary restraining orders, and civil judgments.4