HMO/PSN Quarterly Meeting Performance Improvement Projects

1. HMO/PSN Quarterly MeetingPerformance Improvement Projects September 26 , 2011 Presenter: Christi Melendez, RN, CPHQ Project Manager, PIP Review Team

2. Presentation Topics • Discuss Well-Child Visits in the First 15 Months of Life—Six or More Visits • Results • Discuss Validation Results • Next Steps • Important Dates

3. HMO/PSN Non-Reform Well-Child Visits in the First 15 Months of Life— Six or More Visits Baseline – • Thirteen plans provided baseline results • The overall rate for the Non-Reform HMOs was 34.0 percent • The rates ranged from 11.1 to 80.0 percent

4. HMO/PSN Non-Reform Well-Child Visits in the First 15 Months of Life— Six or More Visits Remeasurement 1 – • Twelve plans provided Remeasurement 1 results • Seven plans reported improved rates from baseline to Remeasurement 1; all increases were statistically significant • The overall rate increased from 34.0 percent to 37.1 percent

5. HMO/PSN Non-Reform Well-Child Visits in the First 15 Months of Life— Six or More Visits Remeasurement 2 – • Ten plans provided Remeasurement 2 results • Seven plans reported improved rates from Remeasurement 1 to Remeasurement 2; two of the increases were statistically significant • The overall rate decreased from 37.1 percent to 30.0 percent

6. HMO/PSN Non-Reform Well-Child Visits in the First 15 Months of Life— Six or More Visits Remeasurement 3 – • Five plans provided Remeasurement 3 results • Two of the five plans reported improved rates from Remeasurement 2 to Remeasurement 3; none of the increases were statistically significant • The overall rate decreased from 30.0 percent to 27.4 percent NOTE:Plans were not required to report Remeasurements 2 or 3 for calendar year 2010

7. HMO/PSN Non-Reform Baseline Well-Child Visits in the First 15 Months of Life—Six or More Visits

8. HMO/PSN Non-Reform Baseline to Remeasurement 1 Well-Child Visits in the First 15 Months of Life—Six or More Visits

9. HMO/PSN Non-Reform Baseline to Remeasurement 2 Well-Child Visits in the First 15 Months of Life—Six or More Visits

10. HMO/PSN Non-Reform Baseline to Remeasurement 3 Well-Child Visits in the First 15 Months of Life—Six or More Visits

11. HMO/PSN Non-Reform Statistically Significant Improvement and Sustained Improvement

12. HMO/PSN Reform Well-Child Visits in the First 15 Months of Life—Six or More Visits Baseline – • Seven plans provided baseline results • The overall rate for the Reform HMO/PSNs was 37.5 percent • The rates ranged from 10.3 percent to 60.0 percent

13. HMO/PSN Reform Well-Child Visits in the First 15 Months of Life—Six or More Visits Remeasurement 1 – • Three plans provided Remeasurement 1 results • One of the three plans reported an improved rate from baseline to Remeasurement 1, the increase was not statistically significant • The overall rate improved from 37.5 percent to 52.7 percent Remeasurement 2 – • One plan provided a Remeasurement 1 rate of 46.2 percent; the result was below the plan’s baseline rate of 48.7 percent NOTE:Plans were not required to report Remeasurements 1 or 2 for calendar year 2010

14. HMO/PSN Reform Baseline Well-Child Visits in the First 15 Months of Life—Six or More Visits

15. HMO/PSN Reform Baseline to Remeasurement 1 Well-Child Visits in the First 15 Months of Life—Six or More Visits

16. HMO Validation Results Across All PIPs (Reform and Non-Reform)

17. PSN Validation Results Across All PIPs

18. Next Steps What’s Next? • New Collaborative Intervention • Work Group • Develop Action Plan • PIPs submitted to HSAG for validation Wednesday, December 14, 2011