Is your clinic missing an opportunity to earn an incentive payment for well-care visits?

Washington State Health Care Authority sent this bulletin at 08/11/2021 03:00 PM PDT

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Is your clinic missing an opportunity to earn an incentive payment for well-care visits?

The Health Care Authority (HCA) sends you this notification on behalf of our partners at the Department of Health (DOH).

The clinic pilot project

If your clinic provides health care for children, the Washington State Department of Health (DOH) may be able to help your clinic earn up to $10,000 in the process!

In DOH's well-child improvement clinic projects, 3 out of 4 clinics improved their well-child visit rates, some by more than 10% in just 5 months!

DOH, in partnership with the Apple Health (Medicaid) Managed Care Organizations (MCOs), is sponsoring another clinic pilot project (August 2021 – January 2022).

The goal of this pilot is to identify the clinic rate for well-child visits for children 0 to 21 years of age and increase them while partnering with two MCOs.

What the clinic will get

Partnership Work with a pair of MCOs to reconcile the list of patients attributed to the clinic (the list used to report the official rate of well-child visits for patients served)
Experience Gain experience using MCO reports (Master Roster, Care Gap Reporting, and Add/Drop Reporting)
Learn tips Opportunity to learn what is reported by other clinics and parents
Incentive Requires completion of 5 tasks, and varies based on the number of children attributed to the clinic by the partnering MCO
Up-to-date enrollee awareness Access to rosters that can be maintained beyond the pilot project

Qualifications

Serve at least 500 Apple Health managed care patients 0 to 21 yrs of age between two MCOs
Well-Child Visit rates in 2020 below any three of the following

W30 ages 0-15 months <54%
W30 15-30 months <68%
WCV ages 3-11 <47%
WCV ages 12-17 <35%
WCV ages 18-21<18%
WCV total, 39%

Clinic is willing to dedicate time and resources between August 2021l – January 2022 and partner with an MCO to complete a series of tasks to increase the rates of well-child visits for identified age groups. The final project report is due in January 2022 (EHR must be able to print a list of clinic patients and the date of their last well-exam).

To learn more about the clinic project...

Contact the two MCOs of your choice below:

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.