1. MCE Quality Based or Value Based Incentive Programs
MDwise

2. MCE Quality Based or Value Based Incentive Programs
HEDIS Follow Up After Hospitalization (FUH)
FSSA offers Pay for Outcomes (P4O) opportunities for the health plans.
On an annual basis, FSSA establishes benchmarks for a set of quality measures defined in the health plan contract and offers additional payment when the health plans meet established goals.
MDwise will evaluate performance rates for all outpatient providers.
MDwise will measure provider group performance on the FUH, 7-day performance measure. The number of eligible members in each provider group that are successful in obtaining a follow-up appointment with 7-days, will determine the per member amount awarded.

3. MCE Quality Based or Value Based Incentive Programs
Community Mental Health Center (CMHC) Integrated Workgroup with MDwise
16 CMHCs participating in 2017
Goal: to improve member compliance with HEDIS measures
HEDIS measures for 2017
Adolescent Well Care
Well Child, Ages 3 - 6
Adult Preventive Care
Diabetic Screening for members with schizophrenia or bipolar disorder that are on an antipsychotic

4. Designed to incentivize members for health-related activities
Rewards Program
Designed to incentivize members for health-related activities
Functions like a traditional rewards program where members accumulate points and “cash” them in
Points earned can be monitored and cashed in via Online web portal or by calling Customer Service
Points are weighted related to the importance of the activity
Rewards to choose from include:
At the $10 level (25 points): Subway, AMC and ITunes
At the $30 level (50 points): Target, Kroger, Speedway and Walgreens;
At the $50 level (75 points): Target, BabysRUs and Kohls
At all levels HIP members can opt to put their dollar amounts towards their monthly POWER Account payment for HIP Plus

5. Activities that earn points
Sign up for Member Web Portal (with an address)
Sign up to receive Healthy Indiana Plan monthly statements online through the my MDwise Member Portal
Completion of a Health Needs Screener (HNS)
Completion of an annual physical exam or well-child visits
Getting recommended mammogram screening
Getting annual cervical cancer screen
Getting recommended prenatal visits
Completing a postpartum exam

6. Activities that earn points (cont’d)
Getting necessary Diabetic screening HbA1c
Lead screening for children 6-24 months
Completing a tobacco cessation program
High Risk members maintaining contact with their Care Manager
Follow-up appointment after a mental health inpatient hospital stay within 7-days
Annual flu shot
Dental exams, 2 times each year