SIM Focus Area Priority Assessment Grid

SIM Core Current Ap Ap App A Impa Availab Comments Measure Dashboard pli pli lica p ctful ility of Measure ca ca ble pl Inter Data bl bl to ic venti beyond e e BHH a ons dashbo to to ? bl Possi ard All H e ble? (H,M,L) Pa H? to ye A rs C ? s? Developmental N Y Y Y Y L/M Screenings Well Child N Y Partial Y Y L/M Visits Children 7-11 N Y Partial Y Some H/M IHOC focus already Access to PC All-cause Y Y Y Y Y H Overall negative trend, need Readmits additional trend information; but is opportunity for savings high enough; this is primarily a hospital measure Diabetic Care Current patients Y Y Y Y Y H Diabetic care for MaineCare (HbA1c) 18-75 with members is lower than for diabetes who have commercial, good opportunity had an HbA1c test across all payers in the last 12 mos Follow up after Y Y Y Y Some M Impactful interventions Hosp for available depending on data Mental Illness availability Non-Emergent Y Y Y Y Y H Good trend in this measure ED use already;should consider dev of categories, bifurcate ed use into physical & behavioral categories Fragmented The percentage of Y Y Y Y Y H If data/results different by Care members with a payers, are totally different fragmented care approaches needed? Could index of greater Care Coordinators look at than .75. A score fragmented care results by of 1 is complete member/practice? fragmentation, a score of 0 is no fragmentation Imaging for Y N N N Y M Low Back Pain Below is the assessment grid developed to assess each SIM Core Measure against a set of criteria to help determine which measure would be the most beneficial for SIM to focus on for the remainder of the SIM Focus Area Priority Assessment Grid cooperative agreement (Year 3 and no-cost extension period). Determined priority areas developed by the SIM Core team are highlighted below, with overall priority level indicated.