1. Performance contracting
Washington state SHIBA

2. Performance Contracting in SHIP and SMP
Todd Dixon, SHIBA Program Manager
Statewide Health Insurance Benefits Advisors
WA State Office of the Insurance Commissioner

3. SHIBA investors (budget)
State Health Insurance Program (SHIP): $900,000
Senior Medicare Patrol (SMP): $200,000
Medicare Improvements for Patients & Providers Act (MIPPA): $180,000
State funding: $1,000,000

4. Washington state SHIBA overview
1.2 million Medicare beneficiaries
14 SHIBA staff
20 SHIBA sponsors
All 20 SHIP
11 of 20 also Senior Medicare Patrol (SMP)
88,000 Client Contact Records (CCRs), 120,000 Public & Media Activities (PMAs), ranking is 13, Average and Good in preliminary Likert

5. SHIBA organization

6. SHIBA regional training consultants

7. Pay for performance 6 performance tiers – contacts and outreach
Tier 4 – 7% penetration, 10% penetration for LIS
Levels 6 – performance payments – 10% and 12%
Pay points for SMP
65% of SHIP budget is allocated to contracts
40% open enrollment, 20% in non OE quarters
Base amount $1,000 per quarter, per county
Legislative language

8. Support for success Field supervisor and regional training consultants
Budget and contracts coordinator
Contracting and procurement training
Customer Service staff in larger counties
Sponsors targeting rural counties
Sponsors targeting Limited-English
Korean Women’s Assoc., Latino Community Fund, Chinese Information Services, farmworker organizations
Event based contracting with diverse community agencies.
Progressive budgeting

9. Example - CCR

10. Example – CCR with fraud (SMP)

11. Example – CCR with low income

12. Sample invoice

13. Payment worksheet