5 Star Workgroup April 11, 2012

Agenda Status of 2012 Interventions 2012 Data Collection Plan –CAHPS and HOS Target 2013 and 2014 Star Rating (if available)

2012 Interventions Member – –Health Guidebook and Incentives AWV Medication Adherence Diabetes Colorectal and Breast Cancer Screening Flu –ESI Medication Adherence Intervention –IVR: RA, Osteoporosis, COPD –Chronic Care Improvement on CV/Diabetes –QIP on Plan All Cause Readmission –MC400/CCMS Care Alerts Pilot May 2012 with Medication Adherence (Statins) Note: need to discuss “Call to Action” for each

2012 Interventions Provider –Provider Quality Star Rating Program (QSRP) –Geriatric Care toolkit “SCANNY Pak” –Angel Vision Videos –Care Alert Program starting Summer, 2012 –CME PIE –California Quality Collaborative –P4P –Chronic Care Improvement Program on CV/Diabetes –QIP on Plan All Cause Readmission

2012 CAHPS CAHPS Health Plan Survey produce the following measures of patient experience: Getting needed care Getting care quickly Overall rating of healthcare quality Health plan information and customer service How people rated their health plan These are included in the 5 Star rating and weighted 1.5.

2012 CAHPS 91 questions in all (SCAN added 8 “supplemental” questions) For MA contracts, the fixed sample size is 800 eligible enrollees. CMS draws the sample. Response rate 50-65%

2012 CAHPS Task NameRevised Pre-notification letter to all sampled members 3/5/2012 First questionnaire 3/12/2012-3/14/2012 Second questionnaire 4/9/2012-4/11/2012 Telephone interviewing 1st attempt 4/30/2012-5/7/2012 Telephone interviewing additional attempts 5/8/2012-5/29/2012 End telephone interviewing 5/29/2012 Completion of data collection 5/29/2012 Deliver data to CMS (RAND) 6/12/2012

2012 Health Outcomes Survey Annual survey of 1,200 randomly selected (non- ESRD) Medicare beneficiaries by MA Contract Collects longitudinal health status data (remeasurement at 2 years) Self-administered mail survey with telephone follow-up Response rate for H5425 Cohort 11 Follow Up was 87% excluding those who died, disenrolled, did not complete baseline, or not seniors.

2012 Health Outcomes Survey Survey Content – 64 questions Physical Health Status Mental Health Status Chronic Medical Conditions Clinical Symptoms Activities of Daily Living Depression Indicator Smoking Status HEDIS – UI/Falls/Physical Activity/Osteo Testing Healthy Days Demographics

2012 Health Outcomes Survey Cohort 15 Baseline and Cohort 13 Follow-Up Survey Administration No significant changes to HOS administration this year. Telephone interviewing will be available in Spanish. The Cohort 15 Baseline survey is scheduled for administration from April–July 2012; The Cohort 13 Follow-Up survey is scheduled for administration from May–August 2012.

2012 Health Outcomes Survey HOS Timeline 2012 Task NameDate Survey vendors obtain phone number files from MAOsEnd of April 2012 First Wave (Baseline Cohort)—Pre-notification postcard mailing Monday, April 2, 2012 First Wave—First questionnaire mailingMonday, April 9, 2012 Second Wave (Follow-Up Cohort)—Pre-notification postcard mailing Monday, April 30, 2012 First Wave—Second questionnaire mailingMonday, May 7, 2012 Second Wave—First questionnaire mailingMonday, May 7, 2012 First Wave—CATI interviewingMonday, June 4–Monday, July 9, 2012 Second Wave—Second questionnaire mailingMonday, June 4, 2012 Second Wave—CATI interviewingMonday, July 2–Monday, July 30, 2012 First and Second Wave—Final data files due to NCQAMonday, August 13, 2012

2012 Health Outcomes Survey The following 5 measures are included in the 5 Star Rating: -Improving or Maintaining Physical Health -Improving or Maintaining Mental Health -Improving Bladder Control -Reducing Risk of Falling -Monitoring Physical Activity

Target 2013/2014 Star Rating If this is ready…otherwise we can present what Moon did in January (see last slide) Assigned ownership to measures Owners estimated targets for 2014 Establish reporting mechanism for each

14 Current Assessment RegionStar Rating January 2012 Assessment: Probability of 2014 Plan Rating AZ3.595% 4.04% CA4.098% 4.52%