Colorado Home Improvement Contract by wbd21056


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                                        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
                           data collection.
                          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
                           administrative measures.
                          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+.

Department                                                                              N/A
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
                              age strata.
                             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#
1:30-3:30 p.m.

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