EQRODelmarva Foundation has evaluated managed care quality for Medicare and Medicaid programs since 1982. We have been a designated External Quality Review Organization (EQRO) by the Centers for Medicare & Medicaid Services (CMS) since 1996, and now have EQR experience in 10 states. Our status assures our clients that they will receive the enhanced federal match, which varies from state to state.

Highly-Qualified and Credentialed Professionals

  • Certified HEDIS Compliance Auditors (CHCA)
  • Certified Professionals HealthCare Quality (CPHQ)
  • Project Management Professionals (PMPs)

Innovative Solutions that Promote Efficiency and Eliminate Waste

  • Web-based solutions for real-time data exchange and customer feedback
  • Customized reporting for clients and their stakeholders, including legislators, MCOs, consumers, and providers
  • Access to an interactive performance management system to give critical feedback on key contract deliverables
  • A network of small business subcontractors, which allows us to exceed subcontracting requirements for current state contracts

EQR

Delmarva Foundation helps Medicaid agencies meet federal EQR regulatory requirements through activities that ensure that beneficiaries have access to care and services that are timely and of the highest quality. We also provide technical and project management support for all mandatory and optional EQR activities.

Delmarva performs EQR activities in Maryland, the District of Columbia, and West Virginia.

Independent Assessment of Medicaid Waivers

Delmarva Foundation is a leader in conducting 1115 waiver program evaluations, including Family Planning and Long-Term Care. We also work with state Children’s Health Insurance Programs (CHIP), evaluating the programs and validating CHIP measures.