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Model Application Template for the State Children’s Health Insurance Program
Effective Date:
Approval Date: 40 Measure 5.6.3: By July 1, 2000, the number of acute inpatient hospital admissions/1000 children with diabetes compared to the previous year will decrease.
Measure 5.6.4: By July 1, 2000, the number of physician office visits/1000 children with diabetes compared to the previous year will increase.
Check the applicable suggested performance measurements listed below that the state plans to use: (Section 2107(a)(4)) 9.3.1.
The increase in the percentage of Medicaid-eligible children enrolled in Medicaid. 9.3.2.
The reduction in the percentage of uninsured children. 9.3.3.
The increase in the percentage of children with a usual source of care. 9.3.4.
The extent to which outcome measures show progress on one or more of the health problems identified by the state. 9.3.5.
HEDIS Measurement Set relevant to children and adolescents younger than 19. 9.3.6.
Other child appropriate measurement set. List or describe the set used. 9.3.7.
If not utilizing the entire HEDIS Measurement Set, specify which measures will be collected, such as: 9.3.7.1. Immunizations 9.3.7.2. Well childcare 9.3.7.3. Adolescent well visits 9.3.7.4. Satisfaction with care 9.3.7.5. Mental health 9.3.7.6. Dental care 9.3.7.7. Other, please list: 9.3.8.
Performance measures for special targeted populations.