Overarching Goal C. Sub Goals: Goal 1: Improve Access to Primary Care Services for Members 90% of initial credentialing of PCPs will be finalized within 75 days of receipt of application. The percentage of Family Practitioners with open panels will increase by four percentage points over baseline. Goal 2: Improve Access to Behavioral Health Services for Members 73% of Behavioral Health Providers will demonstrate Urgent Care Appointment Availability within 24 hours. 91% of Behavioral Health Providers will demonstrate Routine Care Appointment Availability within 10 days. Goal 3: Increase Utilization of New Member Medical Check-Ups within 90 days of Enrollment 90% of new members will receive a reminder/insert in the new member packets to remind members to schedule a new patient check-up. 100% of new members with working phone numbers and with default or no PCP will have a new PCP assignment within 60 days of enrollment. Texas Health and Human Services Commission HMO Performance Improvement Goal Template for State Fiscal Year 2008 (September 1, 2007 – August 31, 2008)
Overarching Goal C. Sub Goals: Goal 1: Improve Access to Primary Care Services for Members 90% of initial credentialing of PCPs will be finalized within 70 calendar days of receipt of application. The percentage of Family Practitioners with open panels will increase by 5 percentage points over baseline. Goal 2: Improve Access to Behavioral Health Services for Members Increase Behavioral Health Urgent Care Appointment Availability by 5 percentage points over baseline. Increase Behavioral Health Routine Care Appointment Availability by 5 percentage points over baseline. Goal 3: Increase Utilization of New Member Medical Check-Ups within 90 days of Enrollment 100% of new members with valid phone numbers will receive three call attempts within 30 days of enrollment to encourage a medical check-up within 90 days of enrollment. 100% of new members that did not select a valid PCP from the plan's network will be defaulated to a local, appropriate network PCP by the 15th of each month. Texas Health and Human Services Commission HMO Performance Improvement Goal Template for State Fiscal Year 2009 (September 1, 2008 – August 31, 2009)
Overarching Goal C. Sub Goals: Goal 1: Improve Access to Primary Care Services for Members §90% of Pediatricians will have open panels §90% of initial credentialing of PCPs will be finalized within 90 days of receipt of application Goal 2: Improve Access to Behavioral Health Services for Members §Increase urgent care appointment availability by 5 percentage points over the baseline §Improve the percent of psychiatrists accepting new member referrals by 5 percentage points over the baseline Goal 3: Improve Current Member Understanding About the CHIP Benefit Renewal Processes §Member Services staff will provide verbal reminders about re-enrollment to 90% of members §Member Services will research 100% of undelivered member mail for updated and valid demographic information Additional information related to the Performance Improvement Goals can be found in Attachment B-1,
Overarching Goal C. Sub Goals: Goal 1: 90% of initial credentialing of PCPs will be finalized Improve Access to Primary Care within 75 days of receipt of application. Services for Members The percentage of Family Practitioners with open panels will increase by 10 percentage points over baseline. Goal 2: Improve Access to Behavioral Health Services for Members Increase Behavioral Health Urgent Care Appointment Availability by 5 percentage points over the baseline. Increase Behavioral Health Routine Care Appointment Availability by 5 percentage points over the baseline. Goal 3: 90% of new members will receive a reminder/insert in the Increase Utilization of New Member Medical Check-Ups new member packets to remind members to schedule a new patient check-up. within 90 days of Enrollment 100% of new members with working phone numbers and with default or no PCP will have a new PCP assignment within 60 days of enrollment. Subject: Attachment B-4 – Performance Improvement Goals Version 1.8 HMO Performance Improvement Goal Template for State Fiscal Year 2008 (September 1, 2007 – August 31, 2008)
Overarching Goal C. Sub Goals: Goal 1: Improve Access to Primary Care Services for Members § 90% of Pediatricians will have open panels § 90% of initial credentialing of PCPs will be finalized within 90 days of receipt of application Goal 2: Improve Access to Behavioral Health Services for Members § Increase urgent care appointment availability by 5 percentage points over the baseline § Improve the percent of psychiatrists accepting new member referrals by 5 percentage points over the baseline Goal 3: Improve Access to Clinically Appropriate Alternatives to Emergency Room Services Outside of Regular Office Hours § Increase the number of providers, including urgent care clinics offering after hour appointments, by 5% over baseline § Target outreach and education to 90% of members who have utilized the emergency room for primary care services ≥ 2 times Additional information related to the Performance Improvement Goals can be found in Attachment B-1, Section 8.1.1.1, to the Contract. Texas Health and Human Services Commission STAR and CHIP HMO Performance Improvement Goals SFY 2007 (September 1, 2006 - August 31, 2007) Modified by Versions 1.2 and 1.4
