region/plan-specific news : Louisiana CSoC

Collaboration helps improve quality of care

Magellan of Louisiana collaborates with providers to investigate and jointly address quality-of-care concerns. The Quality of Care Concern (QOCC) Work Group, under the leadership of Magellan’s Coordinated System of Care unit medical director, oversees this process, which includes:

• Investigating concerns: Magellan conducts a thorough inquiry, gathering information from data reviews, clinical records, and stakeholder feedback. The QOCC Work Group then reviews the findings and determines the best course of action.
• Collaborating with providers: Magellan works closely with providers to address concerns, ensuring they have the tools and guidance needed to investigate and resolve issues. Providers may also conduct their root-cause analysis to identify underlying factors contributing to the problem.
• Developing corrective action plans (CAPs): If a concern is substantiated, Magellan collaborates with providers to develop a corrective action plan (CAP). This plan outlines actionable steps to resolve the issue and prevent future occurrences. Magellan offers technical assistance and continuous support throughout the process. 
• Monitoring and follow-up: Once the CAP is implemented, Magellan continues to provide support by monitoring its progress. The QOCC Work Group ensures that the corrective actions are effective and lead to meaningful improvements.

Through this collaborative approach, Magellan and providers work together to maintain high standards of care and ensure that any concerns are addressed promptly and effectively.