DASHBOARD

The dashboard is now available to authorized users in all PCP, BH, and Hospital Areas of Concentrations (AOCs).

To access the dashboard, go to data.tipqic.org and sign in.


Performance Measurement Tiers & Targets

An AHCCCS Committee in consultation with CHiR established the tiers and targets. The committee considered National Medicaid Performance, AHCCCS Historical Performance, TIP Historical Performance, AHCCCS Minimum Performance Standards (MPS), and TI Fiscal Year 2019 performance to determine TI Year 4 tiers and targets. The identity of the TI participants was blinded.

  • Two to four tiers are established for all measures. To qualify for the performance incentive, Organizations must improve from tier in baseline year to next higher tier in measurement year (top tier to maintain).
    • Organizations in the lowest tier in the baseline year must meet or exceed the above target for the measurement year to qualify for the performance incentive.
    • Organizations in a middle tier in the baseline year must meet or exceed the above target for the measurement year to qualify for the performance incentive. For example, for the Well-Child Visits (Ages 3-6 Years), Peds PCP organizations between 60% and 85% in the baseline year must meet or exceed 85% to qualify for the performance incentive.
    • Organizations in the highest tier, the tier above the high target, in the baseline year must stay above the high target for the measurement year to qualify for the performance incentive.
    • Tiers and targets may differ across AOCs for the same measure. These differences accommodate variation in attribution methodologies.


PCP Tiers & Targets

AOC Measure Description Low Target Middle Target High Target
Peds PCP Well-Child Visits (Ages 3-6 Years): 1 or More Well-Child Visits 60% N/A 85%
Well-Child Visits (Ages 0-15 Months): 6 or More Well-Child Visits 65% N/A 80%
Adolescent Well-Care Visits: At Least 1 Comprehensive Well-Care Visit 40% 60% 80%
Adult PCP Follow-Up After Hospitalization for Mental Illness: 18 and older (30-day 63% N/A 85%
Follow-Up After Hospitalization for Mental Illness: 18 and older (7-day) 50% N/A 75%
Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) 56% N/A 83%

BH Tiers & Targets

AOC Measure Description Low Target High Target
Peds BH Follow-Up After Hospitalization for Mental Illness: 6-17 Years (30-day) N/A 90%
Follow-Up After Hospitalization for Mental Illness: 6-17 Years (7-day) 70% 80%
Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) N/A 50%
Adult BH Follow-Up After Hospitalization for Mental Illness: 18 and older (30-day) N/A 90%
Follow-Up After Hospitalization for Mental Illness: 18 and older (7-day) 70% 80%
Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) 70% 80%

Justice Tiers & Targets

AOC Measure Description Low Target High Target
Justice Initiation of Alcohol and Other Drug Abuse or Dependence Treatment (14-day) TBD TBD
Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (34-day) TBD TBD
Follow-Up After Hospitalization for Mental Illness: 18 and older (30-day) TBD TBD
Follow-Up After Hospitalization for Mental Illness: 18 and older (7-day) TBD TBD
Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) TBD TBD

Hospital Tiers & Targets

AOC Measure Description Low Target High Target
Hospital Follow-Up After Hospitalization for Mental Illness: 18 and older (30-day) N/A 85%
Follow-Up After Hospitalization for Mental Illness: 18 and older (7-day) 60% 70%

Calculations & Data Used

  • ASU is using NCQA-certified software to calculate the TI Year Four HEDIS measures. Providers can access the HEDIS measures via the resources on the Measures page.
  • Information on the PCP and BH provider types and specialties and the attribution processes is provided below.
  • The dashboard highlights the trend performance for TI participant organizations.
  • The dashboard shows a 12-month moving (rolling) average performance.
  • A claim is associated with its date-of-service month.
  • Annual dashboards that drive incentive payment will reflect Federal Fiscal Years (October 1st – September 30th).

Provider Types/Specialties


Attribution


PCP Attribution
  • Please follow this link for details regarding the PCP Attribution Methodology Decision Tree.
    • PCP refers to a Primary Care Provider, including DO, MD, NP and PA.
  • PCP attribution is at the member level.
    • Members are attributed for the entire measurement year.
    • Members are attributed to one PCP for all PCP measures.
  • The most recent member assignments will be used in the attribution process.
  • Milestone performance will be based on attribution to members at the Organizational (Tax ID) level for participating sites.

BH Attribution
  • Attribution methodology for BH providers depends on the measurement criteria.
  • A standard treating physician attribution methodology has been modified to the group level.
  • Details for each BH measure follow:

    Metabolic Monitoring for Children and Adolescents on Antipsychotics
    • Member will be attributed to all BH providers who have treated the patient for this condition (i.e., provided service with a diagnosis of mental illness) during the 12-month reporting period.

    Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications
    • Member will be attributed to all BH providers who have treated the patient for this condition (i.e., provided service with a diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder) during the 12-month reporting period.
    • Example: A member/patient with Schizophrenia regularly sees a Licensed Clinical Social Worker (LCSW) (or Psychologist) for ongoing care and also occasionally sees a Psychiatric NP (or Psychiatrist) for prescription of antipsychotic medication. If a diabetes screening test is completed in the CY, the LCSW (or Psychologist), the Psychiatric NP (or Psychiatrist), and the PCP who completes the diabetes screening test will get credit for the measure. For specific codes, see the HEDIS resources on the Measures page.

    Follow-Up After Hospitalization for Mental Illness (FUH), 7/30-days
    • Attribution is based on each hospitalization episode. The episode will be attributed to all BH providers with whom there is a qualifying follow up visit as well as all TI-participating BH providers with whom the member had a visit in a 90 day window prior to the hospitalization.
    • Day Zero is the day of discharge and is not eligible to be included in the 7/30 days follow up after hospitalization. This is a CMS and NCQA policy. AHCCCS seeks to align with the national standards to the greatest extent possible.

Justice Attribution
  • Performance levels on the Justice measures are based only on the Justice population.
  • The Year 4 performance period reflects all non-SMI AHCCCS members released from incarceration October 2018 – September 2020 (a 24-month period) that are attributed to a TI-participating provider.
  • In Year 4, recently released members are assigned to a Justice Clinic provider based on the member’s residence zip code.

Hospital Attribution
  • Attribution is based on each hospitalization episode. The episode is attributed to the hospital where hospitalization occurred.
  • Day Zero is the day of discharge and is not eligible to be included in the 7/30 days follow up after hospitalization. This is a CMS and NCQA policy. AHCCCS seeks to align with the national standards to the greatest extent possible.

Collaborative Care Model Codes

Psychiatric Collaborative Care Model (CoCM) is an approach to behavioral health integration recognized by CMS. An AHCCCS Committee in consultation with CHiR established how the CoCM services (i.e., codes 99492, 99493 and 99494) will be recognized in the TI Program.

  • PCP measure evaluation (i.e., 7/30-day follow up after hospitalization for mental illness measures): Collaborative codes will count as a qualified visit for numerator.
  • PCP attribution: CoCM codes will not be included among E&M codes or other qualifying visit in PCP attribution process.
  • BH measure evaluation & attribution (i.e., 7/30-day follow up after hospitalization for mental illness measures): In post-discharge period, CoCM codes will count as a qualified visit for numerator. In period prior to hospitalization (i.e., 90 days prior), CoCM codes will qualify the BH provider in denominator.