CCO incentive metrics – 2019 wrap-up

CPCCO only met 60% of quality pool metrics for 2018, we are collectively working hard to meet metric targets for 2019. The targets get harder each year, and we know clinics are putting in extra effort to reach out to patients and complete visits before the end of the year. Current areas of focus are listed below. Please continue to focus on these for the remaining few weeks of the year!

  • Diabetes Poor Control – please ensure patients’ most recent HbA1c values are updated in the EHR data fields
  • Dental visits for people with diabetes
  • Controlling Hypertension - please ensure patients’ most recent BP values are updated in the EHR data fields
  • Effective Contraceptive Use (ECU) – 262 more members need contraception surveillance codes!
  • Adolescent Well Care visits (AWC) – 167 more AWC visits are needed!
  • Childhood Immunizations – please ensure all immunizations are up-to-date in ALERT for 2-year old children
  • Colorectal Cancer Screening – 445 more screenings are needed!

Quality payout distribution for 2019: 20% of the funds to be distributed will be allocated based on meeting the CCO targets. Funds left behind by clinics that don’t meet targets will be distributed through a challenge pool.

  • Challenge pool measures are AWC, ECU, Diabetes Poor Control and Controlling Hypertension

     

    2020 CCO Incentive Metrics

    The metrics are changing in 2020, so we will need to shift focus somewhat while trying to maintain the high-quality processes we have developed over the last few years.

    2020 CCO measure set: We will spend time in the January CAP and Quality Improvement Workgroup meetings reviewing these further.

  • Kindergarten readiness metric 1: preventive dental visits for ages 1-5 and 6-14 bundled measure (i.e. separate benchmarks and we will need to meet both to pass the measure)
  • Kindergarten readiness metric 2: well child visits for ages 3-6
  • Timeliness of postpartum care
  • Disparity measure: ED utilization for members with mental illness
  • Oral evaluation for adults with diabetes
  • Cigarette smoking prevalence
  • Depression screening and follow up
  • Diabetes HbA1c poor control
  • Adolescent immunizations (MCV4, TDaP, HPV)
  • Initiation and engagement for the treatment of alcohol and other substance use disorders
  • SBIRT – alcohol and drug misuse screening, brief intervention, referral to treatment
  • Childhood immunization status
  • Assessments for children in DHS custody

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