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Summary of PMHP Performance Improvement Projects Validation Findings

Summary of PMHP Performance Improvement Projects Validation Findings. Friday, March 25, 2011 3:00 p.m. – 4:00 p.m. Presenter: Donald Grostic, MS Associate Director, State & Corporate Services. Presentation Overview. 2010–2011 PIP Validation Process Validation Findings

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Summary of PMHP Performance Improvement Projects Validation Findings

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  1. Summary of PMHP Performance Improvement Projects Validation Findings Friday, March 25, 2011 3:00 p.m. – 4:00 p.m. Presenter: Donald Grostic, MS Associate Director, State & Corporate Services

  2. Presentation Overview • 2010–2011 PIP Validation Process • Validation Findings • Study Indicator Results • Collaborative Validation Findings • Collaborative Study Indicator Results • Next Steps

  3. 2010–2011 PIP Validation Process • “Statement of Intent” was completed by each MCO type and submitted to HSAG. • For 2010–2011, MCOs were to submit to HSAG two PIPs for validation: • Clinical and nonclinical • Collaborative topic and one other

  4. 2010–2011 PIP Process (cont.) • HSAG selected two PIPs. • One ongoing and one collaborative PIP were chosen. • PIPs selected were chosen based on HSAG’s selection criteria. • If a PMHP did not have a nonclinical study in process and only had clinical studies, then two clinical PIPs were selected for this year’s validation cycle.

  5. Overall PIP Validation Performance 2009–2010 2010–2011

  6. Trending of PIP Validation Scores

  7. Study Indicator(s) Improvement

  8. Statistically Significant Study Indicator(s) Improvement

  9. Study Indicator(s) Sustained Improvement

  10. Overall Collaborative PIP Validation Performance 2009–2010 2010–2011

  11. Trending of Collaborative PIP Validation Scores

  12. Collaborative Study Indicator Improvement

  13. Statistically Significant Collaborative Study Indicator Improvement

  14. Collaborative Study Indicator Sustained Improvement

  15. Next Steps for PMHPs • PMHPs need to address all Points of Clarification and all Partially Met and Not Met evaluation elements. • HSAG has provided the PMHPs with the Word version of the study submitted. • PMHPs should use the same study document to continue working on the PIPs. PMHPs should date, bold, and strike-through any sections in which revisions are made to the study document.

  16. Process for Disputing Validation Score • The plan must submit its dispute via formal letter to HSAG and cc AHCA Contract Manager • The letter should outline the evaluation element/comment being disputed and the plan’s rationale for why the score should be changed • All responses should be e-mailed to ddriscoll@hsag.com no later than April 1, 2011 • The HSAG PIP Review Team will review the dispute and respond to the plan with a decision within seven (7) business days

  17. Questions and Answerson PIP validation?

  18. Upcoming EQR Activities Friday, March 25, 2011 Presenter: Yolanda Strozier, MBA Associate Director, State and Corporate Services

  19. Upcoming EQR activities • The next EQR Quarterly Meetings: • Wednesday, June 8, 2011 (AHCA Offices) One-on-one TA sessions Tuesday, June 7, 2011 • Week of September 26, 2011 (Webinar) • Wednesday, January 11, 2012 (AHCA Offices) One-on-one TA sessions Tuesday, January 10, 2012 • Week of March 19, 2012 (Webinar)

  20. Upcoming EQR activities • Finalization of PIP Validation Reports (April 2011). • Annual PIP Summary Report and Strategic Summary Report (April–June 2011).

  21. Upcoming EQR activities Next Steps • PIPs are submitted to AHCA/DOEA— August 2011 • MCOs will receive HSAG’s “Statement of Intent” (SOI) survey on Wednesday, August 10, 2011. • Completed SOI’s due to HSAG on Monday, August 29th.

  22. External Quality Review Quarterly Meeting THANK YOU FOR YOUR PARTICIPATION!

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