1. NHDP Collaborative PIP Breakout Session Lessons Learned Wednesday, June 10, 2009 10:15 am to 12 noon Presenter: Don Grostic, MS Associate Director, Research and Analysis Team

2. NHDP Collaborative PIP Lessons Learned  The previous collaborative PIP topic used quarterly data collection which created confusion as to when statistical testing and causal/barrier analysis should be done as well as how the data should be aggregated to an annual rate  Small population numbers affected the ability to draw conclusions from the results  Future topics need to be sensitive to attrition and death that affect members in the study population

3. NHDP Collaborative PIP Lessons Learned (continued)  Future collaborative PIPs should include data collection methods that accommodate both large and small NHDP programs  Administrative data collection should be encouraged in the collaborative PIP topic to avoid the complexity of sampling  The collaborative PIP topic should include an area that is an opportunity for all NHDPs. Historical data should support the topic selection

4. NHDP Collaborative PIP Breakout Session Collaborative PIP Survey Results Wednesday, June 10, 2009 10:15 am to 12 noon Presenter: Cheryl Neel, RN, MPH, CPHQ Associate Director, Performance Improvement Projects

5. Collaborative PIP Survey  NHDP PIP Survey distributed to 13 NHDPs on May 1, 2009  Survey responses submitted to HSAG by COB on May 15, 2009  Survey requested the ranking of three proposed study topics  An additional space was included for “other” PIP topics

6. Three Proposed PIP Topics  Timeliness of Services –The study topic would measure the timeliness of a specific service provided by the NHDP.  Member Satisfaction –The study topic would measure specific question(s) from the member survey conducted by the NHDPs.  Length of Stay –The study topic would measure the average number of months from effective date through voluntary disenrollment or admission to long term care. This is currently a Performance Measure.

7. Collaborative PIP Survey Results Results:  10 out of 13 surveys returned to HSAG  None of the proposed study topics took 1 st place  Results comparative across all three topics  Three additional study topics suggested: –Influenza vaccines among NHDP members –Using a any number from 0-10 where 0 is the worst program possible, what number would you use to rate the NHDP? –Voluntary disenrollments choosing to remain in custodial residence

8. Proposed Study Questions/Indicators Submitted Examples of Timeliness of Services Q:“ Was the initial nutrition evaluation conducted within 7 days of the nutrition referral?” I:“The total number of enrollees in the NHDP who had a referral for nutrition evaluation and the number of enrollees who had a nutrition evaluation within 7 days of the nutrition referral during the measurement period.” Q:“Was the member orientation conducted timely for the study period?” I:“Care manager makes scheduled home visit within 5 business days of enrollment.”

9. Proposed Study Questions/Indicators Submitted Examples of Timeliness of Services (cont.) Q:“ Measure the timeliness of a specific service.” I:“Indicators would have to be very specific, i.e., that service and when. Start date easy to pull from claims DOS.”

10. Proposed Study Questions/Indicators Submitted Examples of Member Satisfaction Q:“ Has the care provided from the NHDP helped the caregiver to effectively care for their loved ones?” I:“The total number of enrollees in the NHDP who answered the caregiver question on the DOEA survey and the number of enrollees who answered that the care was effective on the caregiver question during the measurement period.” Q:“Does increased frequency of communication increase the enrollee/representative overall program rating of the health plan?” I:“Numerator=total number of survey respondents score program 7-10; Denominator-total number of survey respondents.”

11. Proposed Study Questions/Indicators Submitted Examples of Member Satisfaction (cont.) Q:“ Will case management interventions result in increased satisfaction for members who are receiving services in their homes, assisted living facilities and nursing facilities?” I:“Using a Likert scale to respond to each survey question the indicator would be sum of responses to survey questions/total responses to survey questions.”

12. Proposed Study Questions/Indicators Submitted Examples of Length of Stay Q:“ What is the average number of months from the effective date of enrollment through voluntary disenrollment or admission to LTC?” I:“Average length of enrollment before voluntary enrollment.” Q:“Does doing the planned intervention improve the average number of months before voluntary disenrollment or admission to LTC?” I:“Use current performance measure indicator.” Q:“Do patient, clinical, and treatment factors contribute to length of stay?” I:“The total number of enrollees in the NHDP who voluntarily disenrolled and the number of enrollees who disenrolled due to similar contributing factors such as clinical needs, patient needs, and treatment needs at the end of the measurement period.”

13. Today’s Meeting Expectations Obtain consensus among NHDPs on: 1. Study topic; 2. Study question(s); and 3. Study indicator(s).

14. Questions ?