As part of its evaluation of Indiana’s Care Select program, B&A is conducting a survey of Primary Medical Providers in January 2009 to assess their level of knowledge and participation in the care management of Medicaid members with long term care needs. This survey will not be a traditional CAHPS survey, but rather a survey that will be tailored to the specific needs of the Care Select review.
B&A produces a monitoring manual for the OMPP each year that addresses access, quality, utilization per 1,000 trends and usage of specific services of Hoosier Healthwise members. With the introduction of the OMPP’s two new programs—Care Select and HIP—the monitoring manual will expand beginning in 2009 to monitor trends across the three programs.
An annual deliverable of B&A’s contract with the OMPP is to conduct a focus study on an aspect of the Hoosier Healthwise program. In 2007, this study related to the incidence of children utilizing services from Primary Medical Providers that they were not assigned to. In 2008, the study included a profile of high cost members in Hoosier Healthwise and the associated capitation payments that MCOs receive for these members.
B&A conducts an annual independent evaluation of Indiana’s Children’s Health Insurance Program. This report includes segments on enrollment trends, access to service, quality indicators and program costs. The report is delivered to the Legislature in April of each year. B&A’s contract began in 2007, but Mark Podrazik has been conducting this annual evaluation for Indiana since 2001. The 2007 and 2008 reports can be found in our Publications section.
B&A serves as the External Quality Review Organization for the Medicaid managed care program, Hoosier Healthwise. An annual evaluation is conducted which includes both a desk review of policies and procedures as well as onsite reviews at the three managed care organizations. B&A conducted reviews in 2007 and 2008 and have been awarded a contract extension through 2012.
Additionally, B&A will be conducting annual reviews beginning in 2009 of OMPP’s other two large-scale Medicaid programs—Care Select (a care management program for clients with long term care needs) and Healthy Indiana Plan (the slimmer package for low-income working uninsured not eligible for Medicaid).
The EQR reports for Hoosier Healthwise in 2007 and 2008 can be found in our Publications section.