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Program Overview Expert Panel March 9, 2005

Program Overview Expert Panel March 9, 2005. Reviewing the Past. Planning the Future. Program Evaluation. How are we doing? What have we learned? What can we do better? What are our priorities?. Challenges. Increase services to eligible women Increase Access to women

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Program Overview Expert Panel March 9, 2005

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  1. Program Overview Expert Panel March 9, 2005 Reviewing the Past. Planning the Future

  2. Program Evaluation • How are we doing? • What have we learned? • What can we do better? • What are our priorities?

  3. Challenges • Increase services to eligible women • Increase Access to women • Increase Choice for all women • Expand CVD services to all eligible women (40-64) • Provide safety net for low income uninsured women

  4. Background • Program Implementation • Planning began in 1992 • Screening began in 1993 • More than 77,000 women screened, reaching an estimated 30% of potentially eligible women in 2004 • Funding • Federal through CDC • National Breast and Cervical Cancer Early Detection Program • WISEWOMAN Well-Integrated Screening and Evaluation for Woman Across the Nation • Massachusetts State Legislature (4570-1500)

  5. Program Requirements • Screening and Diagnostic Services • Case Management • Professional Education • Public Education and Outreach • Quality Assurance • Surveillance and Evaluation

  6. MassHealth • Breast and Cervical Cancer Treatment Program (MBCCTP) • Implemented January 1, 2004 • Expedited enrollment process • 269 women referred in 2004 • Legislative line 4000-0875 • House 1 funding recommendation ~ $5,022,572

  7. Contract Services • 26 Contracting Organizations • Enrollment • Eligibility determination • Provision and clinical management of screening and diagnostic services • Case management • Data submissions/billing • Continuous quality improvement

  8. Breast and Cervical Cancer

  9. Heart Disease and Stroke Prevention

  10. Evaluations • Patient Satisfaction Survey 2002 • Program Services Qualitative Evaluation 2004 • Case Management Evaluation 2004-2005 • Random Sample Client Survey 2005 • Random Sample Provider Survey 2005 • Site Visit Performance Reviews 2004-2005 • Random Sample Chart Audit 2004-2005

  11. Data Review Session • Save the Date • April 7, 2005 • 3:00 - 6:00 p.m. • Landmark Center

  12. Patient Satisfaction Survey • Number of women participating (1,373) • 4 language groups interviewed • Findings stratified by education and language • Mail and phone sample Selected Findings

  13. Patient Satisfaction Survey Selected Findings • Mammogram and Pap screening • Providers explained findings in an easy to understand way • Name recognition • Program awareness • Access to services

  14. Program Services Selected Findings • Program Strengths • Staff commitment to patients • Dedication to program mission • Challenges to program implementation • Administrative • Adherence to clinical guidelines • Staff turnover • Cultural and linguistic influences • Integration of CVD services

  15. Program Services • Selected Recommendations • Streamline administrative responsibilities • Improve availability of professional training • Enhance outreach and public education services • Identification of additional funding and resources

  16. Case Management Selected Findings • Strengths • High client satisfaction • Assessment and planning • Job satisfaction • Challenges • Staff training • Work load • Medical bills

  17. Site Visit • Performance Measures: Designed to assess and monitor contract compliance • Benchmarks Established for: • Timeliness • Appropriateness • Completeness • Accuracy

  18. Site Visit • Timeliness Benchmarks: BCCEDP Program • 1. Diagnostic evaluations must be completed within 60 days • 2. Treatment initiation within 60 days • Exceeded • Breast Diagnostic Evaluations • Cervical Cancer Treatment • Did not meet • Breast cancer treatment • Cervical diagnostic evaluations

  19. Site Visit • Appropriateness Benchmarks: BCCEDP Program • 100% of clients with an abnormal result need follow up services: • Meets: • Rarely or never screened • Did not meet: • Abnormal breast screening follow-up • Abnormal cervical screening follow-up

  20. Site Visit • HDSPP Benchmark: Appropriateness • 90% of clients receive complete CVD screening • 95% of clients receive PACE assessment and plan • Did not meet: • CVD screening • PACE assessment and plan

  21. Chart Audit • What is Reviewed • Random sample of client records • Medical records • Program records • Fiscal records • Sample Findings • Administrative management, 90% compliance • Clinical documentation, 85% compliance

  22. Site Visit • What is Reviewed • Policies and procedures • Compliance with clinical guidelines • Internal process to implement program • Representative Findings • Administrative management, 90% compliance • Clinical documentation, 85% compliance

  23. Other Data Sources • Data Sources • Behavioral Risk Factor Survey • WHN Program Services • Mammography Screening • Cancer Registry • Eligible Women Health Brief • Public Education Distribution Report • Clinical Cost Projection Worksheet • Policy and Procedure Manual

  24. Structural Framework Steering Committee Expert Panel Case Management CARDIOVASCULAR DISEASE: Medical Knowledge and Healthcare Technology DPH Staff Health Disparities and Barriers to Healthcare Access Research Assistants Program Recommendations BREAST AND CERVICAL CANCER: Medical Knowledge and Healthcare Technology Education, Outreach and Enrollment Healthcare Delivery Systems WHN Business Operations and Fiscal Management

  25. WHN Evaluation Timeline • Executive Steering Convenes ~ January 26, 2005 • Expert Panels Convene ~ March 9, 2005 • Ongoing DPH Review • Task Force Meetings (March to May) • Reconvene Expert Panel Report of Recommendations ~ June 1, 2005 • Convene Evaluation/Quality Improvement Task Force • DPH Review of Recommendations ~ Summer 2005 • Writing of RFR Fall 2005 • Release and Review of RFR ~ January to March, 2006 • Implementation of new contracts ~ July 2006

  26. Meeting Agenda • 5:00 p.m. to 5:15 p.m. Task Force Meeting Procedures and Goals • 5:15 p.m. to 7:15 p.m. Task Force Break-Out Sessions with Buffet Dinner • 7:15 p.m. to 8:00 p.m. Meeting Review and Task Force Plans

  27. 4:00-4:20 Registration and Refreshments • 4:20-4:30 Welcome and Project Overview • Russell K. Schutt, Ph.D., Project Director • 4:30-5:00 The Women’s Health Network: Experience and Needs • Mary Lou Woodford, RN, BS, CCM, Director of • Women’s Health Network • 5:00-5:15 Task Force Meeting Procedures and Goals • Cynthia Piltch, Ph.D., Meeting Facilitator • 5:15-7:15 Task Force Break-Out Sessions with Buffet Dinner • Assigned Rooms • 7:15-8:00 Meeting Review and Task Force Plans • 3rd Floor Rotunda • Cynthia Piltch, Ph.D, Meeting Facilitator

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