DSHS- Hall, Judy DSHS- Hall, Judy

created Nov 22, 2013

updated Aug 29, 2016

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Goal 4: Healthy and Safe Communities
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dshs, healthy people, healthy youth, behavioral health, mental health, discharge, inpatient
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Data Source
Mental Health Consumer Information System (CIS), via the System for Communicating Outcomes, Performance & Evaluation (SCOPE-WA), provided by Looking Glass Analytics. BHSIA.
Data Definition
The individual RSN contracts establish a performance target of 75 percent, a baseline for each RSN and quarterly improvement targets that are specific to the RSN’s baseline. If an RSN does not meet its quarterly improvement target, the RSN must develop and initiate a corrective action plan, approved by DSHS, to address the deficiency. If an RSN fails to complete corrective action, DSHS may take additional remedial action that can include financial penalties of up to 5 percent of payment. This measure corresponds to RPM measures 002215 and 002218, and Results Washington Measure 1.3.f. (Increase the percent of mental health consumers receiving a service within 7 days after discharge from inpatient settings from 59% to 65% by 12/31/2014. The target is based on a rolled-up statewide improvement target for all RSNs. Each RSN actually has its own target, based on its historic performance. We will revisit this target in future RSN contracts to eventually push this target to 75%). Between January 1, 2008 and June 30, 2009, services in the Pierce region were provided in Fee-For-Service (FFS) settings. Pierce RSN has been excluded from this analysis if they occurred more than 60 days before the RSN closed. Discharges of unknown RSN have been excluded from this analysis. If a person has less than 7 days between a hospital discharge and admission to the same or another inpatient facility, it is considered one episode. Routine Services are any outpatient services except Crisis, Community Psychoeducation, Psychological Assessment, Integrated Substance Abuse MH Assessment, Engagement and Outreach, Integrated Substance Abuse MH Screening, Request for Services, Interpreter Services, Involuntary Treatment Investigation, Respite Care Services, Rehabilitation Case Management, or Hearing for Involuntary Treatment. Includes discharges from community hospitals and evaluation and treatment (E&T) facilities. The year/quarter is based on the date of the inpatient discharge. All age groups are included. Includes Medicare/Medicaid crossovers. Discharges of unknown RSN have been excluded from this analysis. The consumer's Medicaid eligibility status is determined using the month of discharge. For all reporting periods (annually, from SFY 2008-on), the target is calculated based on the formula for performance requirements under the 11-13 RSN PHIP contract, using the percentage (by each RSN) meeting the metric criteria during the baseline period of Federal Fiscal Quarter 2012/1 and calculating an incremental target against the maximum 75% performance goal, relative to the 50% minimum standard. Calculations for targets are based on the following contract rules: (a) If the Contractor’s baseline is between 0% and 39%, the Contractor must achieve a net increase of at least 5 percentage points during the first and second measurement periods, and must reach 50% by the third measurement; (b) if the Contractor’s baseline is between 40% and 44%, the Contractor must achieve a net increase of at least 5 percentage points during the first measurement period, and must reach 50% by the second measurement; (c) if the Contractor’s baseline is between 45% and 49%, the Contractor must reach 50% within the first measurement period; and (d) once the Contractor’s performance is equal to or greater than 50%, the Contractor must reduce the difference between the performance and the target by 10% at every measurement point.
Data Frequency
Quarterly
Target Rationale
Pending
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