Upcoming EQR Activities Contract Year Two 1:45 p.m. – 2:30 p.m. Peggy Ketterer, RN, BSN, CHCA Executive Director, EQRO Services

Upcoming EQR activities MARK YOUR CALENDARS!!!! The Contract Year 2 EQR Quarterly Meetings are being scheduled as follows: Wednesday, September 26, 2007 (Webinar) Wednesday, January 16, 2008 (AHCA Offices) Wednesday, March 26, 2008 (Webinar) Wednesday, June 18, 2008 (AHCA Offices)

Year Two EQR Activities Validation of PIPs Validation of performance measures Review of compliance with access, structural, and operations standards Strategic reports on consumer-reported surveys Strategic HEDIS ® analysis reports HEDIS ® is a registered trademark of the National Committee for Quality Assurance (NCQA)

Year Two EQR Activities Technical assistance Value-based purchasing methodologies Evaluation of AHCA quality strategy Focused studies Dissemination of EQR information EQRO Technical Report

MCO Roles and Responsibilities related to Year Two EQR Activities

MCO Roles and Responsibilities Validation of Performance Improvement Projects

Validation of PIPs MCO Roles and Responsibilities Provide basic information on the PIPs that are currently underway Complete the PIP form and provide supportive documentation for each PIP selected for validation Review HSAG’s completed PIP tool and summary grid, providing feedback and comments

Validation of PIPs MCO Roles and Responsibilities Participate in the Collaborative PIP activities –Attend Kick-Off Meeting (June 20 th, 2007) –Fill out and maintain individual PIP Form –Participate in monthly conference calls –Facilitate one monthly conference call (with HSAG support)

Validation of PIPs MCO Roles and Responsibilities Participate in the Collaborative PIP activities –Conduct key activities of the PIP following the study design –Implement interventions –Collect and analysis two re-measurements

Project Activity by Month Validation of Performance Improvement Projects (PIPs) Task MayJunJulAugSepOctNovDecJan 07 FebMarAprMayJun PIPs 7/07 – 8/07 PIP Documentation Requested 10/07 – 12/07 Perform individual PIP Analysis 12/07 – 2/08 Prepare Annual Validation Summary Report 1/08 – 4/08 Prepare Annual Strategic Report Ongoing Collaborative PIP Activities 9/07 MCO Submit PIP Forms

MCO Roles and Responsibilities Validation of Performance Measures

Validation of Performance Measures MCO Roles and Responsibilities HMOs and PSN provide 2007 HEDIS ® Baseline Assessment Tool (BAT), Data Submission Tool (DST), and Final Audit Report to HSAG HMOs and PSN complete and forward supplemental questions document to HSAG Establish a contact person if questions arise from the HSAG review team

Validation of Performance Measures MCO Roles and Responsibilities PMHPs and NHDPs: HSAG is working with AHCA and the DOEA (for the NHDPs) to identify and define performance measures to be collected. Once performance measure data has been collected and reported by the PMHPs and NHDPs, HSAG will conduct the validation activities. The time frame for validation activities is yet to be determined.

Project Activity by Month Validation of Performance Measures (PMVs) Task MayJunJulAugSepOctNovDecJan 07 FebMarAprMay PMVs 11/07 – 1/08 Prepare Report 10/07-11/07 Receive MCO documentation 9/07 Request Documentation Ongoing TA to AHCA/DOEA for Performance Measure Development

MCO Roles and Responsibilities Focused Studies

Focused Studies MCO Roles and Responsibilities Collect medical records Receive list of sample cases Identify appropriate providers Collect medical records Forward medical records to Tampa office Provide status reports of medical record pursuit Provide data/information as requested

Project Activity by Month Focused Studies Task JunJulAugSepOctNovDecJan 07 FebMarAprMayJun Focused Studies 7/07 –9/07 Develop Study Criteria for study(s) 9/07 – 10/07 Identify Study Populations and Select Samples 10/07 – 12/07 MCOs Collect Medical Records 01/08 – 3/08 Abstract Medical Records 3/08 – 4/08 Perform Data Analysis 4/08 – 6/08 Prepare Report(s)

Upcoming EQR activities Quarterly EQR meetings (webinar and onsite at AHCA offices) Other meetings (including Collaborative PIP meetings and technical assistance sessions) will be scheduled in conjunction with the quarterly meetings

THANK YOU FOR YOUR PARTICIPATION!