Common use of Adults’ Access to Preventive Clause in Contracts

Adults’ Access to Preventive. Ambulatory Health Services This measure indicates whether adult members are accessing health services. Measure: The percentage of members age 20 and older who had an ambulatory or preventive-care visit. For an MCP which had membership as of February 1, 2006: MCP performance will be evaluated using an MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006. The minimum performance standard in this Appendix (2.c) will be applicable to the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006. The last reporting year using the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006 for performance evaluation is CY 2007; the last reporting year using the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006 for P4P (Appendix O) is CY 2008. For any MCP which did not have membership as of February 1, 2006: Performance will be evaluated using a regional-based statewide approach for all active regions and counties (Mahoning and Trumbull) in which the MCP has membership. Regional-Based Statewide Approach: MCPs will be evaluated statewide, using results for all active regions and counties (Mahoning and Trumbull) in which the MCP has membership. ODJFS will use the first full calendar year of data (CY 2007 ) from all MCPs serving CFC membership as a baseline to determine a statewide minimum performance standard. CY 2008 will be the first reporting year that MCPs will be held accountable to the statewide performance standard for statewide reporting. Statewide performance measure results will be calculated after a sufficient amount of time has passed after the end of the report period in order to allow for claims run out. Appendix M Covered Families and Children (CFC) population

Adults’ Access to Preventive. Ambulatory Health Services This measure indicates whether adult members are accessing health services. Measure: The percentage of members age 20 and older who had an ambulatory or preventive-care visit. For an MCP which had membership as of February 1, 2006: Prior to the transition to the regional-based approach, MCP performance will be evaluated using an MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006. The minimum performance standard in this Appendix (2.c) will be applicable to the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006. The last reporting year using the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006 for performance evaluation is CY 2007CY2007; the last reporting year using the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006 for P4P (Appendix O) is CY 2008. For any MCP which did not have membership as of February 1, 2006: Performance will be evaluated using a regional-based statewide approach for all any active regions and counties (Mahoning and Trumbull) region in which the MCP has had membership. Regional-Based Statewide Approach: MCPs will be evaluated statewideby region, using results for all active regions and counties (Mahoning and Trumbull) included in which the MCP has membershipregion. ODJFS will use the first full calendar year of data (CY 2007 which may be adjusted based on the number of months of managed care membership) from all MCPs serving CFC membership as a baseline an active region to determine a statewide minimum performance standardstandard for that region. CY 2008 will be the first reporting year that MCPs will be held accountable to the statewide performance standard standards for statewide reportingan active region, and penalties will be applied for noncompliance. Statewide performance Performance measure results for that region will be calculated after a sufficient amount of time has passed after the end of the report period in order to allow for claims run out. Appendix M Covered Families and Children (CFC) populationrunout.

Adults’ Access to Preventive. Ambulatory Health Services This measure indicates whether adult members are accessing health services. Measure: The percentage of members age 20 and older who had an ambulatory or preventive-care visit. For an MCP which had membership as of February 1, 2006: Prior to the transition to the regional-based approach, MCP performance will be evaluated using an MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1February1, 2006. The minimum performance standard in this the Appendix (2.c) will be applicable to the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006. The last reporting year using the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006 for performance evaluation is CY 2007CY2007; the last reporting year using the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006 for P4P (Appendix O) is CY 2008. For any MCP which did not have membership as of February 1, 2006: Performance will be evaluated using a regional-based statewide approach for all any active regions and counties (Mahoning and Trumbull) region in which the MCP has had membership. Regional-Based Statewide Approach: MCPs will be evaluated statewideby region, using results for all active regions and counties (Mahoning and Trumbull) included in which the MCP has membershipregion. ODJFS will use the first full calendar year of data (CY 2007 which may be adjusted based on the number of months of managed care membership) from all MCPs serving CFC membership as a baseline an active region to determine a statewide minimum performance standardstandard for that region. CY 2008 will be the first reporting year that MCPs will be held accountable to the statewide performance standard standards for statewide reportingan active region, and penalties will be applied for noncompliance. Statewide performance Performance measure results for that region will be calculated after a sufficient amount of time has passed after the end of the report period in order to allow for claims run out. Appendix M Covered Families and Children (CFC) populationrunout.

Adults’ Access to Preventive. Ambulatory Health Services This measure indicates whether adult members are accessing health services. Measure: The percentage of members age 20 and older who had an ambulatory or preventive-care visit. For an MCP which had membership as of February 1February1, 2006: MCP performance will be evaluated using an MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006. The minimum performance standard in this Appendix (2.c) will be applicable to the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006. The last reporting year using the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006 for performance evaluation is CY 2007; the last reporting year using the MCP’s county-based statewide result for the counties in which the MCP had membership as of February 1, 2006 for P4P (Appendix O) is CY 2008. For any MCP which did not have membership as of February 1, 2006: Performance will be evaluated using a regional-based statewide approach for all active regions and counties (Mahoning and Trumbull) in which the MCP has membership. Regional-Based Statewide Approach: MCPs will be evaluated statewide, using results for all active regions and counties (Mahoning and Trumbull) in which the MCP has membership. ODJFS will use the first full calendar year of data (CY 2007 - which may be adjusted based on the number of months of managed care membership) from all MCPs serving CFC membership as a baseline to determine a statewide minimum performance standard. CY 2008 will be the first reporting year that MCPs will be held accountable to the statewide performance standard for statewide reporting, and penalties will be applied for noncompliance. Statewide performance measure results will be calculated after a sufficient amount of time has passed after the end of the report period in order to allow for claims run out. Appendix M Covered Families and Children (CFC) populationrunout.