Virginia Medicaid


Quality Improvement (QI)

The Quality Improvement Unit works to better the health care and services Virginia Medicaid members receive through monitoring quality data and trends throughout the member care experience, and recommending actions for improvement. The newly launched 2020-2022 DMAS Quality Strategy puts forward four broad AIMS, consistent with the National Quality Strategy and CMS Triple Aim, which establish a comprehensive QI system. The AIMS include:

  • Enhance Member Care Experiences
  • Promoting Effective Patient Care
  • Achieving Smarter Spending, and
  • Improving Population Health

The DMAS Quality Strategy lays out the framework of envisioned Quality Improvement, and methods for measuring progress and outcomes. DMAS Quality Improvement activities seek to drive improvements for members in the Commonwealth Coordinated Care Plus and Medallion 4.0 managed care programs, as well as for members in the Fee-for-Service program. The goal of DMAS QI activities is drive proactive, innovative improvements to care and services that members receive, and to improve member satisfaction with care and services.

Population Health

The Population Health Unit works to improve the quality of care for DMAS members while reducing costs across a broad range of areas including chronic disease, maternal and child health, behavioral health, hospitalizations and readmissions, and other focus areas. The Population Health Unit utilizes data to enable a proactive approach to identifying and preventing adverse outcomes and disease burden among DMAS members, all the while fostering a health equity approach to care and service provision.