Sub Goals. Goal 1: Improve Access to Primary Care Services for Members Increase the number of all new members, ages 12-16, receiving well-care (including THSteps) checkups withing the first 90 days of enrollment by 5 percentage points over baseline by year-end. Increase the number of all new members, ages 3-6, receiving well-care (including THSteps) checkups within the first 90 days of enrollment by 5 percentage points over baseline by year-end. Goal 2: Improve Access to Behavioral Health Services for Members Decrease the percent of STAR Member re-admissions to 10%, that occur within 30 days of discharge from a facility following an inpatient hospitalization with a mental health diagnosis. Improve the rate of attendance at outpatient follow-up visits within 7 days following discharge from an inpatient hospitalization. Goal 3: Improve Quality of Healthcare Increase the number of members enrolled in OB Case Management by 5 percentage points over baseline by year-end. Increase 17P utilization, through identification and administration, to qualified recipients by 10 percentage points over baseline.
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. Subject: Attachment B-5 - Deliverables/Liquidated Damages Matrix STATUS1 DOCUMENT REVISION2 EFFECTIVE DATE DESCRIPTION3 Baseline n/a Initial version of Attachment B-5, Deliverables/Liquidated Damage Matrix. Revision 1.1 June 30, 2006 Contract amendment did not revise Attachment B-5, Deliverables/Liquidated Damage Matrix. Revision 1.2 September 1, 2006 Amended Attachment B-5, Deliverables/Liquidated Damages Matrix, to add a footnote clarifying the deliverable due dates. Also amended the provisions regarding Claims Processing Requirements and the Reporting Requirements for the Claims Summary Report. Revision 1.3 September 1, 2006 Amended Attachment B-5, Deliverables/Liquidated Damages Matrix, performance standard for Provider Directories for the CHIP Perinatal Program. Revision 1.4 September 1, 2006 Contract amendment did not revise Attachment B-5, Deliverables/Liquidated Damage Matrix. Revision 1.5 January 1, 2007 Contract amendment did not revise Attachment B-5, Deliverables/Liquidated Damage Matrix. Revision 1.6 February 1, 2007 Contract amendment did not revise Attachment B-5, Deliverables/Liquidated Damage Matrix. Revision 1.7 July 1, 2007 Amended Attachment B-5, Deliverables/Liquidated Damages Matrix, to add clarifications to the provisions addressing Claims Processing Requirements and the Reporting Requirements for the Claims Summary Report. Revision 1.8 September 1, 2007 Contract amendment did not revise Attachment B-5, Deliverables/Liquidated Damage Matrix. Revision 1.9 December 1, 2007 Contract amendment d...
Sub Goals. Goal 1: Improve Access to Primary Care Services for Members Increase the number of all new members, ages 12-16, receiving well-care checkups by 5 percentage points over baseline by year-end. Increase the number of all new members, ages 3-6, receiving well-care checkups by 5 percentage points over baseline by year-end. Goal 2: Improve Access to Behavioral Health Services for Members Decrease the percent of CHIP Member re-admissions to 10%, that occur within 30 days of discharge from a facility following an inpatient hospitalization with a mental health diagnosis. Improve the rate of attendance at outpatient follow-up visits within 7 days following discharge from an inpatient hospitalization. Goal 3: Improve Quality of Healthcare Increase the number of members enrolled in OB Case Management by 5 percentage points over baseline by year-end. Increase 17P utilization, through identification and administration, to qualified recipients by 10 percentage points over baseline.
Sub Goals. Goal 1: Improve Access to Primary Care Services for Members Increase the number of Post-partum Members who receive their post partum visit by 5 percentage points by year end. Incerease the number of newbor Members who receive at least 2 medical checkups in 2 months by 5 percentage points by year-end. Goal 2: Improve Access to Behavioral Health Services for Members N/A Goal 3: Improve Quality of Healthcare Increase the number of members enrolled in OB Case Management by 5 percentage points over baseline by year-end. Increase 17P utilization, through identification and administration, to qualified recipients by 10 percentage points over baseline.
Sub Goals. Goal 1: Improve treatment for ACSC through reduction of inpatient admissions. Reduce inpatient admissions of uncontrolled DM by 2% by year-end. Reduce inpatient admissions of asthma by 2% by year-end. Goal 2: Improve treatment for ACSC through reduction of emergency department visits. Reduce ER utilization rate for ACSCs by 1% for PCPs with over 100 covered lives (members included must have been with PCP for 90 days). Reduce ER Utilization for asthma by 2% by year-end.
Sub Goals. Goal 1: Improve treatment for ACSC through reduction of inpatient admissions. Reduce inpatient admissions of uncontrolled DM by 2% by year-end. Reduce inpatient admissions of asthma by 2% by year-end. Goal 2: Improve treatment for ACSC through reduction of emergency department visits. Reduce ER utilization rate for ACSCs by 1% for PCPs with over 100 covered lives (members included must have been with PCP for 90 days). Reduce ER Utilization for asthma by 2% by year-end.
A. Health Plan Information Plan Name: Superior HealthPlan HMO Program: STAR+PLUS
B. Overarching Goal C. Sub Goals: Texas Health and Human Services Commission HMO Performance Improvement Project Template for State Fiscal Year 2012 (September 1, 2011 – August 31, 2012)
A. Health Plan Information Plan Name: Superior HealthPlan HMO Program: CHIP Perinatal
B. Overarching Goal
Sub Goals. Network adequacy and access to care, evaluated using the following measures:
Sub Goals. Goal 1-5: Three to five Goals for all applicable HMO Programs to be determined and negotiated prior to FY2008. To be determined for FY2008. Goal 6: (STAR+PLUS HMOs) Increase the use of the Consumer Directed Services (CDS) Program Increase the percentage of enrollees receiving Personal Assistance Services (PAS) through the Consumer Directed Services (CDS) Program by 15% as compared to the baseline rate of ____
