Medical Quality Improvement Committee
Monday, January 8, 2009
Attendees: DHHA: Mary Pinkney, Cindy Ashley, Jennifer Kikla, Tasha Oliver
RMHP: Jackie Hudson
CO Access: Carrie Bandell, April Abrahamson, Reyna Garcia, Battina Kline, Leigh
HSAG: Barbara McConnell, Rachel Henrichs, Diane Somerville, Ryan Fair, Don Grostic,
Christy Melendez, Shawn D. Smith, Terri Wilkens
HCPF: Lesley Reeder, Gloria Johnson (PCPP), Beverly Hirsekorn, Katie Brookler, Laura
Gerard (CHP+), Joy Twesigye (CHP+)
TOPIC Discussion Follow-up
Approval of December notes approved N/A
HEDIS A plan may choose to do only administrative data - Plans will have a chance to
Measures collection on a hybrid measure. give input to the draft report.
For CHP+, the prenatal program will only have data for - Laura will ensure CHP+ plans
Colorado Access; RMHP does not have enough can also review the draft.
member data to measure. - Terri will create an addendum
DHHA and Co Access prefer to use hybrid data describing the administrative-
collection because the results typically demonstrate hybrid differences.
higher impact. - CHP+ will post the report to
The final report should reference the difference their web site.
between collecting and comparing administrative data - The report including managed
vs. hybrid data. care will be posted to the
CHP+ will focus on well child visits, 0-15 months, 3-6 HCPF web site.
years, and adolescent.
If a plan chooses to do only administrative data
collection, they should be aware that they might not
achieve as high a rating as if they would in doing hybrid
HEDIS has two jobs: identifying areas to improve and
demonstrating successes for CMS.
There are concerns over the workload of using hybrid
measures. Plans have the choice of doing hybrid or just
There may not be a large enough sample available to
be useful but until the measure is actually collected, that
cannot be determined.
The measures are compared against national norms,
PCPP & FFS.
Performance The three plans met to develop a Coordination of Care - Prior to sending their final
Improvement PIP projects, the plans will better
Projects It is built upon a focused study from last year define parameters and
They will consider members that have diagnoses of definitions including the
Bipolar, Schizophrenia, Schizophrenia Affective behavioral health conditions,
Disorder and Anxiety Disorder. coordination of care, primary
While the three plans will do the same study, the care, communication with
studies are likely to be unique due to varying whom, and coordination with
environments. For instance, RMHP uses individual whom.
offices more often than metropolitan BHOs. Colorado
Access uses an enhanced care model for outreach.
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TOPIC Discussion Follow-up
A plan may choose to do a targeted intervention during - Study indicators should be
the project period based on preliminary data. In that similar although studies will
case, the study cannot be used as a baseline, but could be initiated at different times
give support for intervention due to utilization measures. by all the plans.
Pre and post measures should be done. - Consultation is available by
Indicators are under development. An example is the state or HSAG if needed.
primary care visits.
Plan Updates RMHP – Beginning preparation for HEDIS; on-site N/A
DHHA – Beginning preparation for HEDIS; on-site
CO Access – Beginning preparation for HEDIS; on-
site audit, PIP, Medical Home and CHP+.
updates The contract amendment for HSAG has been
completed. The amendment transitions the
contract management to Beverly Hirsekorn and
adds a CAHPS survey component for CHP+
CAHPS for Laura Gerard (CHP+) explained that the new effort - If anyone is interested in a FFS
CHP+ stemmed from a state audit recommendation to and PCPP CAHPS comparison
identify client satisfaction. for previous periods, Lesley can
It is not clear whether there will be resources to provide.
continue the effort beyond this year.
Ryan Fair and Shawn E. introduced CAHPS. It
demonstrates a consumer’s perspective on quality
and satisfaction. It touches on services from plans,
primary doctors, specialists and healthcare. The
Agency for Healthcare Research and Quality
developed the tool in the 90’s.
The entire CHP+ program will participate, not just
the state network
There are no plan responsibilities; the report is
The standard instrument will be an average
comparison to the national data, FFS and PCPP by
Health Services Advisory Group (EQRO) sends out
the surveys; plans are not specifically notified; calls
occur April through May.
CAHPS will be submitted to the National Consumer
Assessment of Healthcare Providers and systems
CAHPS Benchmarking Database (NCBD) for risk
adjustment; the results will come out in July or
Next meeting is Location: 4 floor conference room or Call in: 888-742-8686
March 5, 2009, conference ID: 1497872#
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