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Model Application Template for the State Children‟s Health Insurance Program

Effective Date:

Approval Date: 55

Measurement of Performance: Every family approved for the hawk-i program will be asked to complete a health assessment questionnaire for one child in the household. (Refer to Attachment 8). The State has contracted with the Iowa Foundation for Medical Care to analyze the results of the survey, both at the initial submission and the next review (12 months) when the family is asked to complete the survey on their past 12 month's experience. Survey outcomes for hawk-i include: 1) Access to care (unmet need) and regular source of medical care, 2) ER use, 3) Unmet need and regular source of dental care, 4) Unmet need for vision care, pharmacy, and behavioral/emotional care, 5) Receipt of anticipatory guidance 6) Child‟s health status 7) Family environment (e.g., stress) Well-child visits in the third, fourth, fifth and sixth years of life will be measured using HEDIS measurements for both the Medicaid Expansion (M-CHIP) and hawk-i (S- CHIP) programs.

Objective Two: Increase the number of children who have access to health care. Measurement of Performance: Enrollment for the Medicaid expansion and the hawk-i programs will be measured using monthly enrollment reports.

Objective Three: Appropriate use of medications for children diagnosed with asthma. Measurement of Performance Medicaid Expansion (M-CHIP) HEDIS measurement set relevant to children and adolescents younger than 21 without modifications. hawk-i Program (S-CHIP) HEDIS measurement set relevant to children and adolescents younger than 19 with modifications.