The dashboard is now available with FY 2019 data to authorized users in Adult PCP and Peds PCP Area of Concentrations (AOCs). The dashboard will not be available to authorized users in Adult BH and Peds BH AOCs until the end of April 2020.
To access the dashboard, go to data.tipqic.org and sign in
Performance Measurement Tiers & TargetsAn AHCCCS Committee in consultation with CHiR established the tiers and targets. The committee considered National Medicaid Performance, AHCCCS Historical Performance, TIP Historical Performance, AHCCCS Minimal Performance Standards (MPS), and TIP Fiscal Year 2019 performance to determine TIP Year 4 tiers and targets. The identity of the TIP participants was blinded.
PCP Tiers & Targets
Three tiers are established for most PCP measures (except, adolescent well-visit measure has four tiers). 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 adolescent well-visit, organizations between 40% and 60% in the baseline year must meet or exceed 60% 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.
|AOC||Measure Description||Low Target||Middle Target||High Target|
|Adult PCP||30-day follow-up after hospitalization for mental illness, 18+||63%||N/A||85%|
|7-day follow-up after hospitalization for mental illness, 18+||50%||N/A||75%|
|Diabetes screening for people with schizophrenia/bipolar disorder using antipsychotic medications||56%||N/A||83%|
|Peds PCP||Well-child visit, 3-6 years of age||60%||N/A||85%|
|6+ well-child visits in the first 15 months of life||65%||N/A||80%|
|Adolescent well-visit, 12-21 years of age||40%||60%||80%|
BH Tiers & Targets
- BH tiers and targets will be posted by the end of April 2020. The BH attribution method is posted below.
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.
- Monthly dashboards will be available highlighting the trend performance for TI participant organizations.
- The dashboard shows a 12-month moving (rolling) average performance.
- Annual dashboards that drive incentive payment will reflect Federal Fiscal Years (October 1st – September 30th).
Please follow this link for details regarding the PCP Attribution Methodology Decision Tree.
- PCP refers to a Primary Care Provider, including DO, MD, and NP.
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.
- 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 for 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 will be done for 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.