5 Star Workgroup

April 11, 2012

Agenda

• Status of 2012 Interventions

• 2012 Data Collection Plan– CAHPS and HOS

• Target 2013 and 2014 Star Rating (if available)

2012 Interventions

• Member – – Health Guidebook and Incentives

• AWV• Medication Adherence• Diabetes• Colorectal and Breast Cancer Screening• Flu

– ESI Medication Adherence Intervention– IVR: RA, Osteoporosis, COPD– Chronic Care Improvement on CV/Diabetes– QIP on Plan All Cause Readmission– MC400/CCMS Care Alerts

• Pilot May 2012 with Medication Adherence (Statins)

• Note: need to discuss “Call to Action” for each

2012 Interventions

• Provider– Provider Quality Star Rating Program (QSRP)– Geriatric Care toolkit “SCANNY Pak”– Angel Vision Videos– Care Alert Program starting Summer, 2012– CME PIE– California Quality Collaborative– P4P– Chronic Care Improvement Program on

CV/Diabetes– QIP on Plan All Cause Readmission

2012 CAHPSCAHPS Health Plan Survey produce the following measures of patient experience:

•Getting needed care

•Getting care quickly

•Overall rating of healthcare quality

•Health plan information and customer service

•How people rated their health plan

These are included in the 5 Star rating and weighted 1.5.

2012 CAHPS• 91 questions in all (SCAN added 8

“supplemental” questions)

• For MA contracts, the fixed sample size is 800 eligible enrollees. CMS draws the sample.

• Response rate 50-65%

2012 CAHPS

Task Name Revised

Pre-notification letter to all sampled members 3/5/2012

First questionnaire 3/12/2012-3/14/2012

Second questionnaire 4/9/2012-4/11/2012

Telephone interviewing 1st attempt 4/30/2012-5/7/2012

Telephone interviewing additional attempts 5/8/2012-5/29/2012

End telephone interviewing 5/29/2012

Completion of data collection 5/29/2012

Deliver data to CMS (RAND) 6/12/2012

2012 Health Outcomes Survey• Annual survey of 1,200 randomly selected

(non-ESRD) Medicare beneficiaries by MA Contract

• Collects longitudinal health status data (remeasurement at 2 years)

• Self-administered mail survey with telephone follow-up

• Response rate for H5425 Cohort 11 Follow Up was 87% excluding those who died, disenrolled, did not complete baseline, or not seniors.

2012 Health Outcomes SurveySurvey Content – 64 questions

•Physical Health Status

•Mental Health Status

•Chronic Medical Conditions

•Clinical Symptoms

•Activities of Daily Living

•Depression Indicator

•Smoking Status

•HEDIS – UI/Falls/Physical Activity/Osteo Testing

•Healthy Days

•Demographics

2012 Health Outcomes Survey• Cohort 15 Baseline and Cohort 13

Follow-Up Survey Administration

• No significant changes to HOS administration this year. Telephone interviewing will be available in Spanish.

• The Cohort 15 Baseline survey is scheduled for administration from April–July 2012;

• The Cohort 13 Follow-Up survey is scheduled for administration from May–August 2012.

2012 Health Outcomes Survey

HOS Timeline 2012

Task Name DateSurvey vendors obtain phone number files from MAOs

End of April 2012

First Wave (Baseline Cohort)—Pre-notification postcard mailing

Monday, April 2, 2012

First Wave—First questionnaire mailing Monday, April 9, 2012

Second Wave (Follow-Up Cohort)—Pre-notification postcard mailing

Monday, April 30, 2012

First Wave—Second questionnaire mailing Monday, May 7, 2012

Second Wave—First questionnaire mailing Monday, May 7, 2012

First Wave—CATI interviewing Monday, June 4–Monday, July 9, 2012

Second Wave—Second questionnaire mailing Monday, June 4, 2012

Second Wave—CATI interviewing Monday, July 2–Monday, July 30, 2012

First and Second Wave—Final data files due to NCQA

Monday, August 13, 2012

2012 Health Outcomes SurveyThe following 5 measures are included in the 5 Star Rating:

•-Improving or Maintaining Physical Health

•-Improving or Maintaining Mental Health

•-Improving Bladder Control

•-Reducing Risk of Falling

•-Monitoring Physical Activity

Target 2013/2014 Star Rating

• If this is ready…otherwise we can present what Moon did in January (see last slide)

• Assigned ownership to measures

• Owners estimated targets for 2014

• Establish reporting mechanism for each

14

Current Assessment

Region Star Rating

January 2012 Assessment:

Probability of 2014 Plan Rating

AZ 3.5 95%

  4.0 4%

     

CA 4.0 98%

  4.5 2%