Common use of PIPS Clause in Contracts

PIPS. The Health Plan shall perform no less than six (6) Agency approved performance improvement projects. (1) Each PIP must include a statistically significant sample of Enrollees. (2) At least one (1) of the PIPs must focus on Language and Culture, Clinical Health Care Disparities, or Culturally and Linguistically Appropriate Services. (3) At least two (2) of the PIPs must relate to Behavioral Health Services. (4) All PIPs by the Health Plan must achieve, through ongoing measurements and intervention, significant improvement to the quality of care and service delivery, sustained over time, in both clinical care and non-clinical care areas that are expected to have a favorable effect on health outcomes and Enrollee satisfaction. (5) The PIPs must be completed in a reasonable time period so as to allow the Health Plan to evaluate the information drawn from them and to use the results of the analysis to improve quality of care and service delivery every year. (6) Within three (3) months of the execution of this Contract, the Health Plan shall submit, in writing, a description of each of the PIPs to the Agency for written approval. The detailed description shall include: (a) An overview explaining how and why the project was selected, as well as its relevance to the Health Plan’s Enrollees and Providers; (b) The study question; (c) The study population; (d) The quantifiable measures to be used, including a goal or benchmark; (e) Baseline methodology; (f) Data sources; (g) Data collection methodology; (h) Data collection cycle; (i) Data analysis cycle; (j) Results with quantifiable measures; (k) Analysis with time period and the measures covered; (l) Analysis and identification of opportunities for improvement; and (m) An explanation of all interventions to be taken.

PIPS. The Health Plan shall perform no less than six (6) Agency approved performance improvement projects. (1) Each PIP must include a statistically significant sample of Enrollees. (2) At least one (1) of the PIPs must focus on Language and Culture, Clinical Health Care Disparities, or Culturally and Linguistically Appropriate Services. (3) At least two (2) of the PIPs must relate to Behavioral Health Services. (4) All PIPs by the Health Plan must achieve, through ongoing measurements and intervention, significant improvement to the quality Quality of care and service delivery, sustained over time, in both clinical care and non-clinical care areas that are expected to have a favorable effect on health outcomes and Enrollee satisfaction. (5) The PIPs must be completed in a reasonable time period so as to allow the Health Plan to evaluate the information drawn from them and to use the results of the analysis to improve quality Quality of care and service delivery every year. (6) Within three (3) months of the execution of this Contract, the Health Plan shall submit, in writing, a description of each of the PIPs to the Agency for written approval. The detailed description shall include: (a) i. An overview explaining how and why the project was selected, as well as its relevance to the Health Plan’s Plan Enrollees and Providers; (b) ii. The study question; (c) iii. The study population; (d) iv. The quantifiable measures to be used, including a goal or benchmark; (e) v. Baseline methodology; (f) vi. Data sources; (g) vii. Data collection methodology; (h) viii. Data collection cycle; (i) ix. Data analysis cycle; (j) x. Results with quantifiable measures; (k) xi. Analysis with time period and the measures covered; (l) xii. Analysis and identification of opportunities for improvement; and (m) xiii. An explanation of all interventions to be taken.