Performance Improvement Projects. 4.12.5.1 As part of its QAPI program the Contractor shall conduct clinical and non-clinical performance improvement projects in accordance with DCH and federal protocols. In designing its performance improvement projects, the Contractor shall: 4.12.5.1.1 Show that the selected area of study is based on a demonstration of need and is expected to achieve measurable benefit to the Member (rationale); 4.12.5.1.2 Establish clear, defined and measurable goals and objectives that the Contractor shall achieve in each year of the project; 4.12.5.1.3 Measure performance using Quality indicators that are objective, measurable, clearly defined and that allow tracking of performance and improvement over time; 4.12.5.1.4 Implement interventions designed to achieve Quality improvements; 4.12.5.1.5 Evaluate the effectiveness of the interventions; 4.12.5.1.6 Establish standardized performance measures (such as HEDIS or another similarly standardized product); 4.12.5.1.7 Plan and initiate activities for increasing or sustaining improvement; and 4.12.5.1.8 Document the data collection methodology used (including sources) and steps taken to assure data is valid and reliable. 4.12.5.2 Each performance improvement project must be completed in a period determined by DCH, to allow information on the success of the project in the aggregate to produce new information on Quality of care each year. 4.12.5.3 The Contractor shall perform the following required clinical performance improvement projects, ongoing for the duration of the GF Contract period: 4.12.5.3.1 One (1) in the area of Health Check screens; 4.12.5.3.2 One (1) in the area of immunizations; and 4.12.5.3.3 One (1) in the area of blood lead screens. 4.12.5.3.4 One (1) in the area of detection of chronic kidney disease. 4.12.5.4 The Contractor shall perform one (1) optional clinical performance improvement project from the following areas: 4.12.5.4.1 Coordination/continuity of care; 4.12.5.4.2 Chronic care management; 4.12.5.4.3 High volume Conditions; or 4.12.5.4.4 High risk Conditions. 4.12.5.5 The Contractor shall perform the following required non-clinical performance improvement projects:
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Sources: Contract (Centene Corp)
Performance Improvement Projects. 4.12.5.1 4.12.3.1 As part of its QAPI program the Contractor shall conduct clinical and non-clinical performance improvement projects in accordance with DCH and federal protocols. In designing its performance improvement projects, projects the Contractor shall:
4.12.5.1.1 4.12.3.1.1 Show that the selected area of study is based on a demonstration of need and is expected to achieve measurable benefit to the Member (rationale);
4.12.5.1.2 4.12.3.1.2 Establish clear, defined and measurable goals and objectives that the Contractor shall achieve in each year of the project;
4.12.5.1.3 4.12.3.1.3 Measure performance using Quality indicators that are objective, measurable, clearly defined and that allow tracking of performance and improvement over time;
4.12.5.1.4 4.12.3.1.4 Implement interventions designed to achieve Quality improvements;
4.12.5.1.5 4.12.3.1.5 Evaluate the effectiveness of the interventions;
4.12.5.1.6 4.12.3.1.6 Establish standardized performance measures (such as HEDIS or another similarly standardized product);
4.12.5.1.7 4.12.3.1.7 Plan and initiate activities for increasing or sustaining improvement; and
4.12.5.1.8 4.12.3.1.8 Document the data collection methodology used (including sources) and steps taken to assure data is valid and reliable.
4.12.5.2 4.12.3.2 Each performance improvement project must be completed in a time period determined by DCH, to allow information on the success of the project in the aggregate to produce new information on Quality of care each year.
4.12.5.3 4.12.3.3 The Contractor shall perform the following required clinical performance improvement projects, ongoing for the duration of the GF GHF Contract period:
4.12.5.3.1 4.12.3.3.1 One (1) in the area of Health Check screens;
4.12.5.3.2 4.12.3.3.2 One (1) in the area of immunizations; and
4.12.5.3.3 4.12.3.3.3 One (1) in the area of blood lead screens.
4.12.5.3.4 4.12.3.3.4 One (1) in the area of detection of chronic kidney disease.
4.12.5.4 4.12.3.4 The Contractor shall perform one (1) optional clinical performance improvement project from the following areas:
4.12.5.4.1 4.12.3.4.1 Coordination/continuity of care;
4.12.5.4.2 4.12.3.4.2 Chronic care management;
4.12.5.4.3 ; 4.12.3.4.3 High volume Conditions; or 4.12.5.4.4 High risk Conditions.
4.12.5.5 The Contractor shall perform the following required non-clinical performance improvement projects:or
Appears in 1 contract
Performance Improvement Projects. 4.12.5.1 As part of its QAPI program the Contractor shall conduct clinical and non-clinical performance improvement projects in accordance with DCH and federal protocols. In designing its performance improvement projects, the Contractor shall:
4.12.5.1.1 Show that the selected area of study is based on a demonstration of need and is expected to achieve measurable benefit to the Member (rationale);
4.12.5.1.2 Establish clear, defined and measurable goals and objectives that the Contractor shall achieve in each year of the project;
4.12.5.1.3 Measure performance using Quality indicators that are objective, measurable, clearly defined and that allow tracking of performance and improvement over time;
4.12.5.1.4 Implement interventions designed to achieve Quality improvements;; Revised 5/19/2008
4.12.5.1.5 Evaluate the effectiveness of the interventions;
4.12.5.1.6 Establish standardized performance measures (such as HEDIS or another similarly standardized product);
4.12.5.1.7 Plan and initiate activities for increasing or sustaining improvement; and
4.12.5.1.8 Document the data collection methodology used (including sources) and steps taken to assure data is valid and reliable.
4.12.5.2 Each performance improvement project must be completed in a period determined by DCH, to allow information on the success of the project in the aggregate to produce new information on Quality of care each year.
4.12.5.3 The Contractor shall perform the following required clinical performance improvement projects, ongoing for the duration of the GF Contract period:
4.12.5.3.1 One (1) in the area of Health Check screens;
4.12.5.3.2 One (1) in the area of immunizations; and
4.12.5.3.3 One (1) in the area of blood lead screens.
4.12.5.3.4 One (1) in the area of detection of chronic kidney disease.
4.12.5.4 The Contractor shall perform one (1) optional clinical performance improvement project from the following areas:
4.12.5.4.1 Coordination/continuity of care;
4.12.5.4.2 Chronic care management;
4.12.5.4.3 High volume Conditions; or 4.12.5.4.4 High risk Conditions.
4.12.5.5 The Contractor shall perform the following required non-clinical performance improvement projects:or
Appears in 1 contract
Performance Improvement Projects. 4.12.5.1 4.12.3.1 As part of its QAPI program the Contractor shall conduct clinical and non-clinical performance improvement projects in accordance with DCH and federal protocols. In designing its performance improvement projects, projects the Contractor shall:
4.12.5.1.1 4.12.3.1.1 Show that the selected area of study is based on a demonstration of need and is expected to achieve measurable benefit to the Member (rationale);
4.12.5.1.2 4.12.3.1.2 Establish clear, defined and measurable goals and objectives that the Contractor shall achieve in each year of the project;
4.12.5.1.3 4.12.3.1.3 Measure performance using Quality indicators that are objective, measurable, clearly defined and that allow tracking of performance and improvement over time;
4.12.5.1.4 4.12.3.1.4 Implement interventions designed to achieve Quality improvements;
4.12.5.1.5 4.12.3.1.5 Evaluate the effectiveness of the interventions;
4.12.5.1.6 4.12.3.1.6 Establish standardized performance measures (such as HEDIS or another similarly standardized product);
4.12.5.1.7 4.12.3.1.7 Plan and initiate activities for increasing or sustaining improvement; and
4.12.5.1.8 4.12.3.1.8 Document the data collection methodology used (including sources) and steps taken to assure data is valid and reliable.
4.12.5.2 4.12.3.2 Each performance improvement project must be completed in a time period determined by DCH, to allow information on the success of the project in the aggregate to produce new information on Quality of care each year.
4.12.5.3 4.12.3.3 The Contractor shall perform the following required clinical performance improvement projects, ongoing for the duration of the GF GHF Contract period:
4.12.5.3.1 4.12.3.3.1 One (1) in the area of Health Check screens;
4.12.5.3.2 4.12.3.3.2 One (1) in the area of immunizations; and
4.12.5.3.3 4.12.3.3.3 One (1) in the area of blood lead screens.
4.12.5.3.4 4.12.3.3.4 One (1) in the area of detection of chronic kidney disease.
4.12.5.4 4.12.3.4 The Contractor shall perform one (1) optional clinical performance improvement project from the following areas:
4.12.5.4.1 4.12.3.4.1 Coordination/continuity of care;
4.12.5.4.2 Chronic care management;
4.12.5.4.3 High volume Conditions; or 4.12.5.4.4 High risk Conditions.
4.12.5.5 The Contractor shall perform the following required non-clinical performance improvement projects:
Appears in 1 contract
Performance Improvement Projects. 4.12.5.1 As part of its QAPI program the Contractor shall conduct clinical and non-clinical performance improvement projects in accordance with DCH and federal protocols. In designing its performance improvement projects, the Contractor shall:
4.12.5.1.1 Show that the selected area of study is based on a demonstration of need and is expected to achieve measurable benefit to the Member (rationale);
4.12.5.1.2 Establish clear, defined and measurable goals and objectives that the Contractor shall achieve in each year of the project;
4.12.5.1.3 Measure performance using Quality indicators that are objective, measurable, clearly defined and that allow tracking of performance and improvement over time;
4.12.5.1.4 Implement interventions designed to achieve Quality improvements;
4.12.5.1.5 Evaluate the effectiveness of the interventions;
4.12.5.1.6 Establish standardized performance measures (such as HEDIS or another similarly standardized product);
4.12.5.1.7 Plan and initiate activities for increasing or sustaining improvement; and
4.12.5.1.8 Document the data collection methodology used (including sources) and steps taken to assure data is valid and reliable.
4.12.5.2 Each performance improvement project must be completed in a period determined by DCH, to allow information on the success of the project in the aggregate to produce new information on Quality of care each year.
4.12.5.3 The Contractor shall perform the following required clinical performance improvement projects, ongoing for the duration of the GF Contract period:
4.12.5.3.1 One (1) in the area of Health Check screens;
4.12.5.3.2 One (1) in the area of immunizations; and
4.12.5.3.3 One (1) in the area of blood lead screens.
4.12.5.3.4 One (1) in the area of detection of chronic kidney disease.
4.12.5.4 The Contractor shall perform one (1) optional clinical performance improvement project from the following areas:
4.12.5.4.1 Coordination/continuity of care;
4.12.5.4.2 Chronic care management;
4.12.5.4.3 High volume Conditions; or 4.12.5.4.4 High risk Conditions.
4.12.5.5 The Contractor shall perform the following required non-clinical performance improvement projects:or
Appears in 1 contract
Sources: Contract for Provision of Services (Amerigroup Corp)