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Building the Perfect PIP for HMOs and PSNs

Learn how to develop effective Performance Improvement Projects for Health Maintenance Organizations (HMOs) and Provider Sponsored Networks (PSNs), focusing on quality outcomes, data analysis, interventions, and sustained improvement.

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Building the Perfect PIP for HMOs and PSNs

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  1. Building the Perfect PIPforHMOs and PSNs Facilitators: Christi Melendez, RN, CPHQ Manager, Performance Improvement Projects Debbie Chotkevys, DHA, MBA Director, State and Corporate Services

  2. Agenda • Purpose of the PIP • Current and Past PIP Performance • Contents of the PIP • Activity: Building the Perfect PIP

  3. Purpose of the PIP • Identify and measure a targeted area (clinical or nonclinical) • Analyze data and identify opportunities for improvement • Develop and implement interventions to improve performance (in quality and timeliness of and access to care) • Develop a framework to improve health outcomes for the population served

  4. HMO and PSN PIP Performance • HMO PIPs received more Partially Met and Not Met validation status than Met • PSN PIPs with a Met validation status declined by 50 percent and more PIPs received a Partially Met and Not Met validation than in the previous year

  5. Contents of the PIP • Activity 1: Study Topic • Activity 2: Study Questions • Activity 3: Study Indicators • Activity 4: Study Population • Activity 5: Sampling Methods (if sampling used) • Activity 6: Data Collection Procedures • Activity 7: Assess Improvement Strategies • Activity 8: Review Data Analysis and Study Results • Activity 9: Assess for Real Improvement • Activity 10: Assess for Sustained Improvement

  6. Building the Perfect PIP Quality Outcomes Achieved Activity 8: Data Analysis and Study Results Activity 9: Assess for Real Improvement Activity 10: Assess for Sustained Improvement Activity 5: Sampling Methods Activity 6: Data Collection Procedures Activity 7: Assess Improvement Strategies Study Implementation Activity 1: Study Topic Activity 2: Study Question(s) Activity 3: Study Indicator(s) Activity 4: Study Population Study Design

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