5 Star Workgroup

1. 5 Star Workgroup April 11, 2012

2. Agenda Status of 2012 Interventions 2012 Data Collection Plan CAHPS and HOS Target 2013 and 2014 Star Rating (if available)

3. 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

4. 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

5. 2012 CAHPS CAHPS 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.

6. 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%

7. 2012 CAHPS

8. 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.

9. 2012 Health Outcomes Survey Survey 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

10. 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.

11. 2012 Health Outcomes Survey

12. 2012 Health Outcomes Survey The 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

13. 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 14