FY 2012 State and Regional Primary Care Associations (PCA)

Funding Opportunity Announcement (FOA)

Data Clarification TA CallApril 5, 2012

Overview

• Health Center Conditions Report

• State Performance ProfileA. Health Center Program Requirement

GoalB. Clinical Performance Improvement

GoalsB2. Financial Performance Improvement

Goals

2

Health Center Conditions Report

Number of Health Center Programs Grantees with Conditions

State

Total number of unique grantees with conditions 7

Health Center Program Conditions# of grantees**

R.1.1 Updated Needs Assessment 1

R.2.2 Documentation of After Hours Coverage 1

R.2.4 Revised Sliding Fee Scale Discount Plan 1

R.3.1 Revised Clinical Performance Measures Forms 2

R.3.1 Revised Financial Performance Measures Forms 2

R.4.1 Board Approved Continuity of Care Plan 1

R.5.1 Contractual/Affiliation Agreements 1

R.5.4 Board Approved Corrective Action Plan to Address Audit Findings 1

R.5.5 Documentation of Accounting Policies and Procedures 1

R.6.1 Revised Board Approved Budget 1

R.7.1 Documentation of Appropriate Board Authority 2

R.7.3 Board Approved Plan for Recruiting a Representative Patient Majority 1

Conditions related to the 19 key program requirements can be found at http://bphc.hrsa.gov/about/requirements/index.htmlA grantee can have multiple conditions (do not add the last column to total unique grantees)

3

Health Center Program Requirement Goal

• Metric: % of Health Center Program grantees with no program conditions on their Notice of Awards (NoAs)

• Definition: Currently funded H80 Grantees that do not have any program conditions in the last 12 months– Program conditions relate to compliance with the 19

key program requirements (http://www.bphc.hrsa.gov/about/requirements/index.html)

4

Clinic Performance Improvement Goals

• Metric: % of Health Center Program grantees in the state/region that meet or exceed performance on one or more Healthy People (HP) 2020 performance measure goal(s)

• Definition: Met or exceeded the ‘Healthy People (HP) 2020’ performance measure goals on at least one of the clinical measures

• Formula:

5

# of grantees who meet or exceed HP 2020 goals on at least one clinical measure

# of 2010 UDS grantees

Clinical Performance Improvement Goals (cont’d)

• Metric: % Children Immunized is 80.0% or higher

• Definition: Met or exceeded the HP 2020 performance measure goal(s) of 80.0% or higher for ‘% Children Immunized’ clinical measure in the 2010 UDS

• Formula:

6

# of grantees who meet or exceed HP 2020 goals for '% Children Immunized'

# of 2010 UDS grantees that reported on this clinical measure

Clinical Performance Improvement Goals (cont’d)

• Metric: % Diabetic Patients with HbA1c less than or equal to 9% is 85.4% or higher

• Definition: Met or exceeded the HP 2020 performance measure goal(s) of 85.4% or higher for ‘% Diabetic Patients with HbA1c less than or equal to 9%’ clinical measure in the 2010 UDS

• Formula:

7

# of grantees who meet or exceed HP 2020 goals for ‘% Diabetic Patients with HbA1c ≤ 9%’

# of 2010 UDS grantees that reported on this clinical measure

Clinical Performance Improvement Goals (cont’d)

• Metric: % Female Patients with PAP Test is 93.0% or higher

• Definition: Met or exceeded the HP 2020 performance measure goal(s) of 93.0% or higher for ‘% Female Patients with PAP Test’ clinical measure in the 2010 UDS

• Formula:

8

# of grantees who meet or exceed HP 2020 goals for ‘% Female Patients with PAP Test’

# of 2010 UDS grantees that reported on this clinical measure

Clinical Performance Improvement Goals (cont’d)

• Metric: % Hypertensive Patients with BP less than 140/90 is 61.2% or higher

• Definition: Met or exceeded the HP 2020 performance measure goal(s) of 61.2% or higher for ‘% Hypertensive Patients with BP less than 140/90’ clinical measure in the 2010 UDS

• Formula:

9

# of grantees who meet or exceed HP 2020 goals for ‘% Hypertensive Patients with BP < 140/90’ # of 2010 UDS grantees that reported on this

clinical measure

Clinical Performance Improvement Goals (cont’d)

• Metric: % Low Birth Weight is 7.8% or lower

• Definition: Met or exceeded the HP 2020 performance measure goal(s) of 7.8% or lower for ‘% Low Birth Weight’ clinical measure in the 2010 UDS

• Formula:

10

# of grantees who meet or exceed HP 2020 goals for ‘% Low Birth Weight’

# of 2010 UDS grantees that reported on this clinical measure

Clinical Performance Improvement Goals (cont’d)

• Metric: % Prenatal Patients Served in the 1st Trimester is 77.9% or higher

• Definition: Met or exceeded the HP 2020 performance measure goal(s) of 77.9% or higher for ‘% Prenatal Patients Served in the 1st Trimester’ clinical measure in the 2010 UDS

• Formula:

11

# of grantees who meet or exceed HP 2020 goals for ‘% Prenatal Patients Served in the 1st Trimester’

# of 2010 UDS grantees that reported on this clinical measure

Clinical Performance Improvement Goals (cont’d)

• Metric: % of Health Center Program grantees with Patient-Centered Medical Home (PCMH) recognition

• Definition: Grantees as of March 12, 2012 that currently have PCMH recognition for at least one site. Only sites recognized within the past 3 years will be considered to be PCMH recognized. Data includes PCMH Recognition through NCQA, The Joint Commission, and AAAHC.

• Formula:

12

# of 2010 UDS grantees

# of grantees who currently have PCMH recognition for at least one site

Financial Performance Improvement Goals

• Metric: % of Health Center Program grantees with cost increase less than National average

• Definition: Grantees whose ‘percent increase in cost per patient’ is less than the CMS National Health Expenditure rate (NHE)– The CMS NHE is 3.94% (

http://www.cms.gov/NationalHealthExpendData/03_NationalHealthAccountsProjected.asp#TopOfPage)

• Formula:

13

# of 2010 UDS grantees

# of grantees whose 'percent increase in cost per patient' < CMS NHE rate

Financial Performance Improvement Goals (cont’d)

• Metric: % of Health Center Program grantees without going concern issues

• Definition: Grantees that currently have no going concern issues identified in their audit report for the 2010 submission year and the report has been reviewed as of March 28, 2012

• Formula:

14

# of grantees without going concern issues # of grantees whose 2010 audit report has been reviewed

as of March 28, 2012