MY5 Final P4P Scorecards
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MY5 Final P4P Scorecards Lauren Wetterhahn 2 Overview • CNYCC Phase 3 Measurement Year 5 Pay-for-Performance Scorecard Review • MY5 Final Performance Payment Methodology • Example Scorecard • Payment Timeline • Q&A 3 CNYCC Phase 3 Measurement Year 5 Pay-for-Performance Scorecard Overview MY5 Final Pay for Performance Scorecard – Overview • Uploaded to partner Sharefile folders on 9/18 – please email [email protected] if you need assistance with accessing your organization’s folder • Consolidates information from the following documents: • Appendix 3 of Phase 3 Contract • Phase 4 Q4 Performance Activity Scorecard • MY5 Final PPS-Level Performance Results • Previous P4P Scorecards (MY4 Final, MY5 Interim, and MY5 Final “Part 1”) • Indicates payment status and amount earned for measures for which a partner was contracted • Partner vs PPS • Targets met? • PA threshold met? • Measure Allocation including any roll-over from previous periods MY5 Final Pay for Performance Scorecard – Overview, cont. • Payment for measures with a PARTNER level target type was finalized in the MY5 P4P Final Part 1 Scorecards • All PARTNER level measures in the MY5 Final P4P “Part 2” show N/A for all columns • Note: If in your MY5 Final P4P Part 1 scorecard distributed earlier this spring, there were PARTNER level measures where no result could be calculated for your organization (N/A for target met), the available funding was rolled forward into this scorecard and the measure was changed to a PPS level measure (very uncommon) 6 MY5 Final Performance Payment Methodology MY5 Final Performance Payment Methodology • Measures with PPS level targets are earned if BOTH the PPS hit the target for the measure AND the partner hit 80% (10/12) of their Phase 4 Threshold PAs: • PA_401 • PA_402 • PA_403_A-D • PA_404_A-B • PA_405_A-B • PA_406 • PA_413 • Unlike in MY4 and MY5 interim scorecards, unearned funding cannot be rolled over to a future performance period but is instead forfeited & will be reallocated by the CNYCC Finance Committee, Board of Directors, and Members 8 Scorecard Overview 9 Example MY5 P4P Final Part 2 Scorecard – First Page Comment explains lack of earnings: Based on PPS target or DOH-provided, threshold missed PPS-level data (or both) Matches Appendix 3 of MY5 Final Part 2 Initial + Phase 3 Project Addendum MY4/MY5 Roll Forward = MY5 Final Part 2 Total 10 Example MY5 P4P Final Part 2 Scorecard – Last Page Total Earnings 11 Payment Timeline and Q&A Payment Timeline • MY4 Final P4P Rebase Payment – Part 1 – released 9/14 • MY5 Final P4P Payment – released 9/18 • COVID-19 Financially Fragile Partner Payments • Hospitals – week of 9/21 • Clinics – end of September • CBOs – early October • Other FFS – October • MY4 Final P4P Rebase Payment – Part 2 – TBD • Phase IV VBP Readiness & VBP Implementation 2 – early November Questions & Answers 14 Appendix 15 Final MY5 PPS Performance Results – Measure Targets Met 1. Adult Access to Preventative or Ambulatory Care - 65 and older 2. PDI 90 - Composite of all measures 3. PQI 90 - Composite of all Measures 4. Primary Care - Length of Relationship - Q3 5. Primary Care - Usual Source of Care - Q2 6. Controlling High Blood Pressure 7. Diabetes Screening for People with Schizophrenia or Bipolar Disease who are Using Antipsychotic Medication 8. Follow-up after hospitalization for Mental Illness – within 30 days 9. Follow-up after hospitalization for Mental Illness – within 7 days 10. Health Literacy (QHL13) - Instructions Easy to Understand 11. Health Literacy (QHL14) - Describing How to Follow Instructions 16 Final MY5 PPS Performance Results – Measure Targets Met 12. Antidepressant Medication Management – Effective Acute Phase Treatment 13. Antidepressant Medication Management – Effective Continuation Phase Treatment 14. Percentage of patients indicating need who were offered or provided an intervention for pain symptoms experienced during the week 15. Percentage of patients indicating need who were offered/provided an intervention for physical symptoms (other than pain) experienced during the past week 16. Percentage of patients indicating need who were offered or provided an intervention for not feeling at peace during the past week 17. Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia 18. C&G CAHPS For the Uninsured - Getting Timely Appointments 19. C&G CAHPS For the Uninsured - How Well Providers Communicate with Patients 20. C&G CAHPS For the Uninsured - Patients' rating of the provider or doctor 17 Final MY5 PPS Performance Results – Measures Targets Missed 1. Adult Access to Preventative or Ambulatory Care - 20 to 44 (Rate Per 100) 2. Adult Access to Preventative or Ambulatory Care - 45 to 64 (Rate Per 100) 3. PAM Score 4. Potentially Avoidable ER Visits (Rate Per 100) 5. Potentially Avoidable Readmissions (Rate Per 100,000) 6. Non-use of Primary and Preventive Care Services 7. Care Coordination (Q13, 17 and 20) 8. Children's access to Primary Care - 12 to 24 months (Rate Per 100) 9. Children's access to Primary Care - 25 months to 6 years (Rate Per 100) 10. Children's access to Primary Care - 7 to 11 years (Rate Per 100) 11. Children's access to Primary Care - 12 to 19 years (Rate Per 100) 12. ED Use by uninsured 13. Getting Timely Appointments, Care and Information (Q6, Q8 and Q10) 18 Final MY5 PPS Performance Results – Measures Targets Missed 14. HCAHPS - Care Transition Metrics (Q23 to Q25) 15. Adherence to Antipsychotic Medications for People with Schizophrenia 16. Diabetes Monitoring for People with Diabetes and Schizophrenia 17. Engagement of Alcohol and Other Drug Dependence Treatment 18. Initiation of Alcohol and Other Drug Dependence Treatment 19. Flu Shots for Adults Ages 18 – 64 20. Follow-up care for Children Prescribed ADHD Medications - Continuation Phase 21. Follow-up care for Children Prescribed ADHD Medications – Initiation Phase 22. Health Literacy (QHL16) - Explained What to do if Illness Got Worse 23. Med. Asst. w/ Smoking & Tobacco Use Cessation - Advised to Quit 24. Med. Asst. w/ Smoking & Tobacco Use Cessation - Discussed Cessation Medication 25. Med. Asst. w/ Smoking & Tobacco Use Cessation - Discussed Cessation Strategies 26. Potentially Preventable Emergency Room Visits (for persons with BH diagnosis) 19 Final MY5 PPS Performance Results – Measures Targets Missed 27. Prevention Quality Indicator # 8 (Heart Failure) ± 28. Prevention Quality Indicator # 7 (Hypertension) ± 29. Percentage of patients indicating need who were offered or provided an intervention for depressive feelings experienced during the past week 30. Percentage of patients who were offered or provided an intervention when there was no advance directive in place 31. Screening for Clinical Depression and follow-up 32. Statin Therapy for Patients with Cardiovascular Disease - Received Statin Therapy 33. Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% 34. C&G CAHPS For the Uninsured - Helpful, Courteous and respectful office staff.