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Breakout Session #1 Shared Best Practices HMOs/PSNs. Yolanda Strozier MBA Project Manager, EQRO Services. Identify the Goal. Written statement Be specific Use numeric values Be realistic but still make it a stretch. Establish a Method to Measure Progress.
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Breakout Session #1 Shared Best Practices HMOs/PSNs Yolanda Strozier MBA Project Manager, EQRO Services
Identify the Goal • Written statement • Be specific • Use numeric values • Be realistic but still make it a stretch
Establish a Method to Measure Progress Example of Measurement of Improvement: Numerator: • Number of successful outreach attempts to members who are due for a postpartum visit Denominator: • Total number of members who are due for a postpartum visit
Examples of High Performers The following Florida Plansmet or exceeded national HEDIS benchmarks (High Performance Levels): • Staywell (Reform)- Well Child Visits 3 to 6 Years • Humana (Non-Reform) & Preferred (Reform) - Diabetes, LDL-C Screening • SFCCN (Non-Reform) - Diabetes, Nephropathy • Vista SF (Reform) - Diabetes, Good HbA1c Control • Citrus (Non-Reform) & Preferred (Reform)- Controlling High Blood Pressure
Examples of High Performers Examples of successful intervention strategies presented by Florida’s high performers Open discussion and brainstorming
Available Resources • http://www.chcs.org provides toolkits, case studies, sample materials, and other resources • http://www.qualityprofiles.org provides a variety of case studies and tools for most HEDIS measures • http://www.ihi.org/ihi provides improvement strategies, resources, and educational opportunities
Available Resources • http:// www. mahp.org/events/pinnacles/08pinnaclebook.pdf provides examples of best practices among Michigan health plans • http:// www.innovations.ahrq.govPromotes exchange of information and dissemination of health care service delivery innovations and quality tools. It also includes attempts, along with level of evidence (strong, moderate, low, insufficient).