- Details
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Office of MaineCare Services (OMS)
Engagement
Member/Provider Total Call Volume – Aggregation: Sum
- Metric Explanation: The total call volume from Providers and Members to the Gainwell, Non-Emergency Transportation, Pharmacy Help Desk, Kepro, and Accentra Call Centers, recorded on a quarterly basis.
- Visual Explanation: A line graph where the horizontal axis can either indicate a quarterly or yearly timeframe, and the vertical axis indicates the number of calls to the Gainwell, Non-Emergency Transportation, Pharmacy Help Desk, Kepro, and Accentra Call Centers.
Member/Provider Total Calls Abandoned – Aggregation: Sum
- Metric Explanation: The total number of calls from Providers and Members to the Gainwell, Non-Emergency Transportation, Pharmacy Help Desk, Kepro, and Accentra Call Centers that were abandoned, recorded on a quarterly basis.
Call Abandon Rate – Aggregation: Sum
- Metric Explanation: The percent of calls that were abandoned ("Number of Calls Abandoned") out of the total calls from Providers and Members to the Gainwell, Non-Emergency Transportation, Pharmacy Help Desk, Kepro, and Accentra Call Centers ("Total Member & Provider Call Volume").
Utilization
Preventive Service Measure – Dental Preventive Benefit Use (Adult or Child)
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Metric Explanation: The percent of benefit-eligible members who received at least one oral evaluation or prophylaxis cleaning within the report period, where 'report period' is the twelve-month measurement period ending on the last day of the month indicated by the report period.
You can switch between viewing the percent of eligible adults OR children that have utilized the dental preventive benefits described above.
Preventive Service Measure – Access to Ambulatory Services for Adult Medicaid Beneficiaries with substance use disorders (SUDs)
- Metric Explanation: The percentage of Medicaid beneficiaries with a substance use disorder who had an ambulatory or preventive care visit within the measurement period (calendar year).
Impact
Percent of Services Touched by Rate Reform
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Metric Explanation: The percent of MaineCare services that were touched by Rate Determination in a Fiscal Year.
Rate Determination is a process conducted by the department to establish the reimbursement rate methodology, base rate amount or payment model for a MaineCare section of policy or for a specific covered service.