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Onsite Quarterly Meeting SIPP PIPs

Onsite Quarterly Meeting SIPP PIPs. Presenter: Christy Hormann, LMSW , CPHQ Project Leader-PIP Team. June 13, 2012. Overview of Presentation. Progression of SIPP PIPs SFY 2012 validation results Areas for improvement. SFY 2011 SIPP PIPs. First year SIPPs completed the PIP process

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Onsite Quarterly Meeting SIPP PIPs

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  1. Onsite Quarterly MeetingSIPP PIPs Presenter: Christy Hormann, LMSW, CPHQ Project Leader-PIP Team June 13, 2012

  2. Overview of Presentation • Progression of SIPP PIPs • SFY 2012 validation results • Areas for improvement

  3. SFY 2011 SIPP PIPs • First year SIPPs completed the PIP process • Each SIPP required to submit one PIP • Total of 14 PIPs were submitted

  4. SFY 2011 SIPP PIPs cont. • One was completed through Activity VI • 13 were completed through VIII • Initial scores were lower due to lack of the proper documentation

  5. SFY 2012 SIPP PIPs • For SFY 2012, the SIPPs were required to submit the collaborative PIP and a PIP topic of their choosing • Some of the individual SIPP topics were increasing family participation in treatment, minimizing weight gain during treatment, and reducing readmissions

  6. SFY 2012 SIPP PIPs cont. • There were a total of 27 PIPs submitted for validation • Six PIPs were assessed through Activity VI • Four PIPs were assessed through Activity VII • Five PIPs were assessed through Activity VIII

  7. SFY 2012 SIPP PIPs cont. • Twelve PIPs were assessed through Activity IX • None of the PIPs were assessed for Activity X-Sustained Improvement

  8. PIP Stages

  9. Study Design Stage • Establishes methodological framework for the PIP • Includes development of study topic, question, indicators, and population (Activities I through IV) • A strong study design is necessary for the successful progression of a PIP

  10. Study Design Stage Evaluation Elements Activity I: Study Topic • Reflects high-volume or high-risk conditions • Is selected following collection and analysis of data

  11. Study Design StageEvaluation Elements Activity I: Study Topic • Addresses a broad spectrum of care and services • Includes all eligible populations that meet the study criteria • Does not exclude members with special health care needs • Has the potential to affect member health, functional status, or satisfaction

  12. Study Design StageEvaluation Elements Activity II: Study Question • States the problem to be studied in simple terms • Is answerable

  13. Study Design StageEvaluation Elements Activity III: Study Indicators • Are well-defined, objective, and measurable • Are based on current, evidence-based practice guidelines, pertinent peer-reviewed literature, or consensus expert panels • Allow for the study question to be answered

  14. Study Design StageEvaluation Elements Activity III: Study Indicators • Measure changes (outcomes) in health or functional status, member satisfaction, or valid process alternatives • Have available data that can be collected on each indicator

  15. Study Design StageEvaluation Elements Activity III: Study Indicators • Are nationally recognized measures, such as HEDIS technical specifications, when appropriate • Includes the basis on which indicator(s) was adopted, if internally developed

  16. Study Design StageEvaluation Elements Activity IV: Study Population • Is accurately and completely defined • Includes requirements for the length of a member’s enrollment in the MCO • Captures all members to whom the study question applies

  17. SIPP Design Stage Results

  18. Study Implementation Stage • Includes sampling, data collection, and interventions (Activities V through VII) • During this stage, MCOs collect data, evaluate and identify barriers to performance, and development interventions targeted to improve outcomes • The implementation of effective improvement strategies is necessary to improve PIP outcomes

  19. Study Implementation StageEvaluation Elements Activity V: Sampling • Consider and specify the true or estimated frequency of occurrence • Identify the sample size • Specify the confidence level • Specify the acceptable margin of error

  20. Study Implementation StageEvaluation Elements Activity V: Sampling • Ensure a representative sample of the eligible population • Are in accordance with generally accepted principles of research design and statistical analysis

  21. Study Implementation Stage Evaluation Elements Activity VI: Data Collection • The identification of data elements to be collected • The identification of specified sources of data • A defined and systematic process for collecting baseline and remeasurement data • A timeline for the collection of baseline and remeasurement data

  22. Study Implementation Stage Evaluation Elements Activity VI: Data Collection • Qualified staff and personnel to abstract manual data • A manual data collection tool that ensures consistent and accurate collection of data according to indicator specifications • A manual data collection tool that supports interrater reliability

  23. Study Implementation Stage Evaluation Elements Activity VI: Data Collection • Clear and concise written instructions for completing the manual data collection tool • An overview of the study in written instructions

  24. Study Implementation Stage Evaluation Elements Activity VI: Data Collection • Administrative data collection algorithms/ flow charts that show activities in the production of indicators • An estimated degree of administrative data completeness

  25. Study Implementation Stage Evaluation Elements Activity VII: Interventions • Related to causes/barriers identified through data analysis and quality improvement processes • System changes that are likely to induce permanent change • Revised if the original interventions are not successful • Standardized and monitored if interventions are successful

  26. SIPP Implementation Stage Results

  27. Outcomes Stage • The final stage of the PIP process (Activities VIII through X) • Involves data analysis and the evaluation of improvement based on the reported results and statistical testing • Sustained improvement is achieved when outcomes exhibit improvement over multiple measurements

  28. Outcomes Stage Evaluation Elements Activity VIII: Data Analysis • Are conducted according to the data analysis plan in the study design • Allow for the generalization of results to the study population if a sample was selected • Identify factors that threaten the internal or external validity of findings • Include an interpretation of findings

  29. Outcomes Stage Evaluation Elements Activity VIII: Data Analysis • Are presented in a way that provides accurate, clear, and easily understood information • Identify the initial measurement and the remeasurement of the study indicators • Identify statistical differences between the initial measurement and the remeasurement

  30. Outcomes Stage Evaluation Elements Activity VIII: Data Analysis • Identify factors that affect the ability to compare the initial measurement with the remeasurement • Include an interpretation of the extent to which the study was successful

  31. Outcomes Stage Evaluation Elements Activity IX: Real Improvement • The remeasurement methodology is the same as the baseline methodology • There is documented improvement in processes or outcomes of care • The improvement appears to be the result of planned intervention(s) • There is statistical evidence that observed improvement is true improvement

  32. Outcomes Stage Evaluation Elements Activity X: Sustained Improvement • Repeated measurements over comparable time periods demonstrate sustained improvement or that a decline in improvement is not statistically significant

  33. SIPPs Outcomes Stage Results

  34. SIPP Indicator Results • There were a total of 44 study indicators • 22 were not assessed for improvement • 15 demonstrated improvement • Of those that demonstrated improvement, 11 demonstrated statistically significant improvement

  35. SIPP Indicator Results

  36. Common Areas for Improvement Activity I: Study Topic • No historical plan-specific data provided to support the selection of the study topic (Evaluation Element #2)

  37. Common Areas for Improvement Activity IV: Study Population • Length of enrollment required not specified (Evaluation Element #2)

  38. Common Areas for Improvement Activity VI: Data Collection • Timeline for data collection not provided (Evaluation Element #4) • Not all information regarding manual data collection was provided (Evaluation Elements #5-9)

  39. Common Areas for Improvement Activity VIII: Data Analysis • Baseline data and data analysis not reported in this year’s submission (Evaluation Elements #1-5)

  40. Recommendations • Use the PIP Summary Form Completion Instructions when documenting the PIP Summary Form • If you have questions, contact HSAG for technical assistance

  41. HSAG Contacts For any PIP questions or to request PIP technical assistance contact: Christy Hormann chormann@hsag.com 602-801-6836 Jenny Montano jmontano@hsag.com 602-801-6851

  42. Questions

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