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 eight domains of care and four 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
- Influenza Vaccination: Percentage of members who received an influenza vaccination in the last year.
- Pneumococcal Immunization: Percentage of members age 65 or older, who received a pneumococcal vaccination in the last five years or after age 65.
- Dental Exam: Percentage of members who received a dental exam in the last year.
- Eye Exam: Percentage of members who received an eye exam in the last year.
- Hearing Exam: Percentage of members who received a hearing exam in the last two years.
- Mammogram/Breast Exam: Percentage of female members ages 50-74, who received a mammogram or breast exam in the last two years.
Patient Safety
- No Falls with Injury: Risk-adjusted percentage of members who did not experience falls that resulted in major or minor injury in the last 90 days.
- No Emergency Room Visits: Risk-adjusted percentage of members who did not have an emergency room visit in the last 90 days.
Advance 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
- Not Lonely or Not Distressed: Risk-adjusted percentage of members who were not lonely or 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.
- Involved in Decisions: Risk-adjusted percentage of members who responded that they are usually or always involved in making decisions about their plan of care.
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/registered 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: Risk-adjusted percentage of members who reported that within the last six months the home health aide/personal care aide/personal assistant services were usually or always on time.
ADL Stable or Improved
- ADL Stable or Improved: Risk-adjusted percentage of members who remained stable or demonstrated improvement in ADL function.
Pain Intensity Stable or Improved
- Pain Intensity Stable or Improved: Risk-adjusted percentage of members who remained stable or demonstrated improvement in pain intensity.
Shortness of Breath Stable or Improved
- Shortness of Breath Stable or Improved: Risk-adjusted percentage of members who remained stable or demonstrated improvement in shortness of breath.
Urinary Continence Stable or Improved
- Urinary Continence Stable or Improved: Risk-adjusted percentage of members who remained stable or demonstrated improvement in urinary continence.
