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NHDP Collaborative PIP Meeting – Timeliness of Services PIP. Global Issues:. Activity I – Defining the Study Topic.
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Overall, PIPs received lower score for not meeting documentation requirements regarding plan-specific data (Evaluation Element 2). If there was not plan-specific data available, include a statement that says this and provide a rationale. We are looking for historical data that supports the selection of the study topic.
Ensure that study indicator documentation is identical to descriptions in the PIP methodology
Numerators and Denominators should include the services member has received.
For example, The number of newly enrolled members who received Adult Day Health
Services should be included in the Numerator and Denominator.
Denominators should also state that members have been continuously enrolled in the NHDP for at least 10 days
The continuous enrollment criteria and member exclusion information also needs to be included in the study population definition (Activity 4, Defining the Study Population)
Identifying Data Elements – Identify the data used to obtain the study indicators.
Describe what the data is and where it comes from (i.e. – the types of files/reports)
Describe how plan determines newly enrolled members for inclusion in the study
Explain how all of the data elements come from all of the data sources – How is data
Provide all of the steps for how data is collected and how it is used to calculate the
study indicators. This description can be provided in the form of an algorithm, data
flow chart, or narrative. We want to see the logical step by step procedures used in
Manual Data Collection – Provide the tool used for data collection (*Critical Element), include written instructions for completing the tool that describes step by step how data will be collected in the tool, and an explanation or overview of the study in the written instructions. (Example would be a screen shot from computerized documentation if data is entered in a computer database)
Administrative – Identify the data being pulled/extracted. Provide claims or billing codes needed to identify the required data elements.
Hybrid – Explain how administrative and manually collected data comes together. How the data is joined to create the study indicators.