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HomeMy WebLinkAboutMINUTES - 09202011 - C.49RECOMMENDATION(S): APPROVE and AUTHORIZE the Purchasing Agent to the purchase of gift cards in an amount of $11,520 as set forth in the attachment, to be used as an incentive to receive preventive care. The California Department of Health Care Services recommends incentives to promote healthy behavior and proposal and programs were created following their guidelines. FISCAL IMPACT: Funds come from Contra Costa Health Plan premiums and are expected to result in lowering costs by encouraging appropriate preventive care. BACKGROUND: Since 2000, the Board of Supervisors has approved utilization of small incentives for CCHP members. Incentives are tied to the Healthcare Effectiveness Data and Information Set (HEDIS), which is used to determine how many default Medi-Cal members are assigned to CCHP, and subsequently increases the capitation CCHP is paid by the State. Ultimately, the higher APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 09/20/2011 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Gayle B. Uilkema, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor Contact: Patricia Tanquary, 313-6004 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: September 20, 2011 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: Tasha Scott, Kevin Drury, Demetria Gary C.49 To:Board of Supervisors From:William Walker, M.D., Health Services Director Date:September 20, 2011 Contra Costa County Subject:CCHP Member Incentives to Promote Better Health Behaviors the HEDIS rate the higher the default rate BACKGROUND: (CONT'D) and capitation rate becomes, so the investment in incentives is expected to pay off monetarily. W&I Code, Section 14407.1 and Title 28, CCR, Section 1300.46 authorize the use of non-monetary incentives to promote good health practices provided they are pre-approved by the Department of Health Care Services. The CCHP incentive program goals for 2011-12 are attached. The request is a decrease of almost $2000 from last year. CONSEQUENCE OF NEGATIVE ACTION: Discontinuation of the incentive program would be expected to lead to a decrease in HEDIS rates, lowering the public's estimation of the Plan and possibly keeping us from participation in offering future products. This decrease would negatively affect the number of Medi-Cal members who are assigned to our plan when they do not express a preference between us and Blue Cross. Currently, 100% of these recipients are assigned to CCHP. A decrease in the default assignment rate would mean receiving capitation for fewer people. CHILDREN'S IMPACT STATEMENT: Expected program outcomes include 1) an increase in children receiving annual well visits. This is likely to positively affect their health and likely to decrease their overall health costs for which we must pay; 2) an increase in the rate of timely prenatal care, resulting in less health problems and less cost; 3) an increase in our interventions to fight pediatric obesity, leading to an decrease in that epidemic and the associated health risks. ATTACHMENTS G:\C&G DIRECTORY\NON CONTRACTS\WORD & PDF FILES\Incentive proposal FY11-12.doc Incentive FY10-11 Request FY11-12 Request Justification Good Health Check Up: Members 0-11 years who make and keep a well visit appointment receive $10 Target gift card. $8880 $8880 Supports multiple HEDIS measures by ensuring regular preventive care. Expect about same number at same incentive rate. Adolescent well visit, ages 12-21. $5 Target gift card awarded for 1 comprehensive provider visit per year. $2520 $0 Discontinue. This is no longer a Medi-Cal measure, and the clinical evidence for the need of healthy adolescents to have annual visits is not strong. Baby Watch: $20 Target gift card for pregnant women who receive their first prenatal visit in their first trimester (or within 42 days of new enrollment). $20 Target gift card for receiving post partum visit 3-8 weeks after delivery. $420 $840 Increase to $20 from $10 each. Prenatal HEDIS rate is close to the Minimum Performance Level set by the state. Also, we want to see whether this will help with a current disparity in postpartum rates. Living Well with Diabetes: 18-75 y/o who complete five important diabetes-related examinations and tests in 12 month period receive $20 Target gift card. $400 $800 Supports several components of the Comprehensive Diabetes Care HEDIS measure and improves management of diabetes. Increasing amount of request to account for prevalence of Diabetes in new SPD population. Pediatric Weight Management: 3-18 year old medically obese members who complete a CCHP-approved program for healthy eating habits and/or exercise receive $20 gift card. $1000 $1000 Helps fight obesity epidemic. Total $13,220 $11,520