Upcoming EQR ActivitiesContract Year Two
1:45 p.m. – 2:30 p.m.
Peggy Ketterer, RN, BSN, CHCAExecutive Director, EQRO Services
Upcoming EQR activities
MARK YOUR CALENDARS!!!!The Contract Year 2 EQR Quarterly
Meetings are being scheduled as follows:Wednesday, September 26, 2007 (Webinar)
Wednesday, January 16, 2008 (AHCA Offices)
Wednesday, March 26, 2008 (Webinar)
Wednesday, June 18, 2008 (AHCA Offices)
Year Two EQR Activities
•Validation of PIPs
•Validation of performance measures
•Review of compliance with access, structural, and operations standards
•Strategic reports on consumer-reported surveys
•Strategic HEDIS® analysis reportsHEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)
Year Two EQR Activities
•Technical assistance
•Value-based purchasing methodologies
•Evaluation of AHCA quality strategy
•Focused studies
•Dissemination of EQR information
•EQRO Technical Report
Validation of PIPsMCO Roles and Responsibilities
• Provide basic information on the PIPs that are currently underway
• Complete the PIP form and provide supportive documentation for each PIP selected for validation
• Review HSAG’s completed PIP tool and summary grid, providing feedback and comments
Validation of PIPsMCO Roles and Responsibilities
• Participate in the Collaborative PIP activities– Attend Kick-Off Meeting (June 20th, 2007)– Fill out and maintain individual PIP Form– Participate in monthly conference calls– Facilitate one monthly conference call (with
HSAG support)
Validation of PIPsMCO Roles and Responsibilities
• Participate in the Collaborative PIP activities– Conduct key activities of the PIP following the
study design– Implement interventions– Collect and analysis two re-measurements
Project Activity by MonthValidation of Performance Improvement Projects (PIPs)
Task May Jun Jul Aug Sep Oct Nov Dec Jan 07
Feb Mar Apr May Jun
PIPs 7/07 – 8/07PIP Documentation
Requested
10/07 – 12/07Perform individual
PIP Analysis
12/07 – 2/08Prepare Annual
Validation Summary Report
1/08 – 4/08Prepare Annual Strategic Report
OngoingCollaborative PIP Activities
9/07MCO Submit PIP Forms
Validation of Performance MeasuresMCO Roles and Responsibilities
• HMOs and PSN provide 2007 HEDIS® Baseline Assessment Tool (BAT), Data Submission Tool (DST), and Final Audit Report to HSAG
• HMOs and PSN complete and forward supplemental questions document to HSAG
• Establish a contact person if questions arise from the HSAG review team
Validation of Performance MeasuresMCO Roles and Responsibilities
PMHPs and NHDPs:• HSAG is working with AHCA and the
DOEA (for the NHDPs) to identify and define performance measures to be collected.
• Once performance measure data has been collected and reported by the PMHPs and NHDPs, HSAG will conduct the validation activities. The time frame for validation activities is yet to be determined.
Project Activity by MonthValidation of Performance Measures (PMVs)
Task May Jun Jul Aug Sep Oct Nov Dec Jan 07
Feb Mar Apr May
PMVs
11/07 – 1/08Prepare Report
10/07-11/07Receive MCO documentation
9/07
Request Documentation
Ongoing TA to AHCA/DOEAfor Performance Measure Development
Focused StudiesMCO Roles and Responsibilities
Collect medical records• Receive list of sample cases • Identify appropriate providers• Collect medical records• Forward medical records to Tampa office • Provide status reports of medical record pursuit
• Provide data/information as requested
Project Activity by Month Focused Studies
Task Jun Jul Aug Sep Oct Nov Dec Jan 07
Feb Mar Apr May Jun
Focused Studies
7/07 –9/07Develop Study
Criteria for study(s)
9/07 – 10/07 Identify Study
Populations and Select Samples
10/07 – 12/07MCOs Collect Medical
Records
01/08 – 3/08Abstract Medical
Records
3/08 – 4/08Perform Data
Analysis
4/08 – 6/08Prepare
Report(s)
Upcoming EQR activities
•Quarterly EQR meetings (webinar and onsite at AHCA offices)
•Other meetings (including Collaborative PIP meetings and technical assistance sessions) will be scheduled in conjunction with the quarterly meetings
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