HABNQC Low Incidence States Quality Management Initiative

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HAB/NQC Low Incidence States Quality Management
Initiative Summary of 16 Participant States
Quality Management Programs Activities
August, 2006
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Low Incidence States QM Initiative

• A HAB-sponsored initiative of the National
  Quality Center (NQC)
• Sixteen low incidence states participating
• Initiative began with a consultative meeting on
  June 26 27, 2006

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Low Incidence States QM InitiativeOVERVIEW

• Share successful strategies resources with HAB
  and each other.
• Develop a TA strategy and an implementation plan
  for LI states that is informed by work already
  being done.

4
Low Incidence States QM InitiativeOVERVIEW

• Develop a body of information that can inform
  ongoing policy and expectations.
• Develop TA documents and tools that provide
  useful information on how to successfully
  implement QM programs.

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Low Incidence States QM InitiativeOVERVIEW

• Assist LI states in managing the quality of their
  programs.
• Assist LI states in complying with QM legislative
  mandates.

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Low Incidence States QM InitiativeOVERVIEW

• Identify expert consultants who can provide
  appropriately focused TA.
• Develop a document that provides useful TA
  information on how to implement a QM program.

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Low Incidence States QM InitiativePRE-MEETING
SUMMARY

• The participating states completed a survey and a
  self-assessment of their QM activities (pre-work
  for the meeting.)
• Each state presented information about their
  programs at the meeting.

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Summary of QM Programs Activities
Sixteen (16) States Participating

• Alaska
• Hawaii
• Idaho
• Iowa
• Kansas
• Maine
• Montana
• New Hampshire

• New Mexico
• Rhode Island
• South Dakota
• Utah
• Vermont
• Virgin Islands
• West Virginia
• Wyoming

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(No Transcript)
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State Overviews
Alaska

• State Population 655,435
• PLWH/A (estimated) 542
• QM Priorities/Activities
• Focus on CM services ADAP
• Annual site evaluation
• Review of required reports
• Includes client interviews
• surveys

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State Overviews
Hawaii

• State Population 1,211,537
• PLWH/A (estimated) 2,603
• QM Priorities/Activities
• Case management standards
• Client file review
• Client satisfaction survey
• ADAP 6-month re-certification
• ADAP collects clinical data

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State Overviews
Idaho

• State Population 1,300,000
• PLWH/A (estimated) 1,000
• QM Priorities/Activities
• Adherence / CD4 viral load
• Track medication ordering
• Case management site visits
• Client satisfaction survey
• Monthly contractor reports
• Intake for both ADAP case
• management
• Annual re-certification

13
State Overviews
Iowa

• State Population 2,936,760
• PLWH/A (estimated) 1,342
• QM Priorities/Activities
• Case Management Standards
• Piloting acuity scale
• Standardized CM forms
• Case Managers trainings
• Provider Update Meetings

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State Overviews
Kansas

• State Population 2,744,687
• PLWH/A (estimated) 2,572
• QM Priorities/Activities
• Working on QM Plan
• Measures selected
• Clinical
• Case management
• ADAP

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State Overviews
Maine

• State Population 1,274,923
• PLWH/A (estimated) 1,500
• QM Priorities/Activities
• Written CM standards forms
• Quality Assurance policies
• CM outputs outcomes identified
• CM training programs
• Chart reviews
• Site visits
• CAREWare implemented
• Client provider satisfaction surveys

16
State Overviews
Montana

• State Population 950,000
• PLWH/A (estimated) 550
• QM Priorities/Activities
• Input requested from internal staff
• and planning group, which includes
• external stakeholders consumers.
• Client-level statewide data is
• collected and informally assessed.
• Case managers receive TA twice
• a year.

17
State Overviews
New Hampshire

• State Population 1,261,970
• PLWH/A (estimated) 1,000
• QM Priorities/Activities
• NH Community Planning Group conducts
• a resource inventory gaps analysis.
• Needs assessment conducted targeting
• PLWH/A, IDUs and racial/ethnic
• minorities.
• Statewide data collection.
• Participating in State Strategic Partnership
• with Region 1 HRSA office.

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State Overviews
New Mexico

• State Population 1,800,000
• PLWH/A (estimated) 2,000
• QM Priorities/Activities
• Compliance with contracts
• Compliance with PHS
• Statewide case management
• standards
• Annual site visit
• Measure CD4 and viral load
• Case manager certification

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State Overviews
Rhode Island

• State Population 1,000,000
• PLWH/A (estimated) 3,500-4,200
• QM Priorities/Activities
• Standards of Care for primary care,
• ADAP case management
• Conduct baseline chart reviews
• Collect data disseminate to providers.
• Conduct several trainings about QM.
• Identify specific QM projects.

20
State Overviews
South Dakota

• State Population 754,844
• PLWH/A (estimated) 288
• QM Priorities/Activities
• Viral load and CD4 counts
• Medicine adherence
• Consumer survey
• Annual re-certification
• Case management chart
• review

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State Overviews
Utah

• State Population 2,582,371
• PLWH/A (estimated) 1,935
• QM Priorities/Activities
• Priorities are medical care new
• patient entry into the system.
• Data collected on a quarterly basis.
• QI plans with providers.
• Medical patient record review.

22
State Overviews
Vermont

• State Population 600,000
• PLWH/A (estimated) 600
• QM Priorities/Activities
• QA Standards in place.
• Evaluation of compliance with
• standards corrective action process.
• Conduct Quality of Life and client satisfaction
  surveys.
• Provider and standard grantee reports on
  performance measures.

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State Overviews
Virgin Islands

• State Population 108,605
• Living AIDS (estimated) 244
• (2002)
• QM Priorities/Activities
• CD4 and viral load
• HAART adherence
• TB tests
• Hep A B vaccination

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State Overviews
West Virginia

• State Population 1,815,354
• PLWH/A (estimated) 1,318
• QM Priorities/Activities
• Adherence to HAART
• Access to primary care
• Enrollment in Medicare Part D
• Client satisfaction survey

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State Overviews
Wyoming

• State Population 493,782
• PLWH/A (estimated) 194
• QM Priorities/Activities
• Basic performance measurement
• systems in place.
• Utilization data collected.
• Limited TA resources to train
• providers.

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Quality Management Program Summary
QM Program Survey
Written Statewide QM Plan (44)
Performance/Outcome Measures Selected (88)
QM Committee In place (56)
Conducted QI project In last 12 mo. (63)
Process to evaluate QM Program (38)
Medicaid Participation On QM committee (31)
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Quality Management Program Summary
The kind of performance/outcome measures
identified.

• Clinical 68.75 of states
• Case Management 68.75 of states
• ADAP 68.75 of states
• Other
• Client Satisfaction
• Housing
• Patient Rights
• Outreach
• Medical record completeness
• Language

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Conclusions

• 44 of states have a written QM plan and 56
  have a QM committee in place.
• 88 of states have performance/outcome measures
  selected.
• 63 have done a QI project in the last 12
  months.

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Conclusions

• Case management and ADAP are most commonly cited
  programs with QM activities.
• All the states collect data 69 collect
  statewide data.
• All 16 states have the capacity to do some level
  Quality Management.