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population. BadgerCare Plus enrollees will have fewer preventable hospitalizations than a comparison population. Enrollees in BadgerCare Plus will report they are satisfied with the quality of care they receive.

Delivery system impacts. Wisconsin predicts that BadgerCare Plus will produce positive results relating to delivery system impacts. BadgerCare Plus will not result in employers reducing their health insurance benefit packages. Persons enrolling in BadgerCare Plus will not drop existing coverage to enroll in BadgerCare Plus. Enrollment in BadgerCare Plus will increase the likelihood of obtaining employment. Enrollment in BadgerCare Plus will reduce the likelihood that an enrollee will utilize welfare services. BadgerCare Plus will result in greater HMO capacity in Wisconsin. BadgerCare Plus will result in long-term savings for the Medicaid program.

9.3 Describe how performance under the plan will be measured through objective, independently verifiable means and compared against performance goals in order to determine the state’s performance, taking into account suggested performance indicators as specified below or other indicators the state develops: (Section 2107(a)(4)(A),(B)) (42 CFR 457.710(d))

A table entitled "Timeframes and Specific Objectives/Goals for Phase 1 of BadgerCare" is included as Appendix B of this document. A summary of how performance under the plan will be measured follows.

Data Sources/Analysis Plan

The analysis plan uses a variety of approaches and multiple data sources. Some aspects of the analysis are much more difficult to quantify than others. While there is considerable existing data available, some analyses will require primary data collection through direct contact via a survey or other means. Some parts of the evaluation will require the development of a control or comparison group to determine program impact.

Baseline Data

The state will measure these types of outcomes and behavior from standard enrollment data available from the CARES system and utilization data reported by BadgerCare HMOs. BadgerCare HMOs will provide the state summary utilization survey data on key indicators (PAP tests, mammograms, immunizations, HealthChecks, mental health and substance abuse evaluations, emergency room visits, etc.) as well as complete utilization history for all BadgerCare recipients. In addition, beginning in the year 2000, BadgerCare HMOs will be required to submit complete encounter data for all their recipients. Access and utilization data for the general population is available in reports and databases produced and maintained by the Department's Office of Health

WISCONSIN

Effective Date:

Approval Date: 62