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Care Information, the Department's Center for Health Statistics, and the Wisconsin Office of the Commissioner of Insurance.

With this comprehensive utilization data available, the State will be able to analyze BadgerCare access and utilization data and compare it to traditional Medicaid populations and general populations. Wisconsin has been in the forefront of states in its ability to report health care utilization and status across Medicaid, commercial, and other public program populations, and to measure utilization rates and health status indicators against defined public goals such as the Wisconsin Public Health Agenda 2000.

The reporting and evaluation of BadgerCare will continue that tradition.

Subsequent data collection

The primary sources of data envisioned for this evaluation are as follows:

• Surveys - An enrollee satisfaction survey will be administered to obtain data to test a number of hypotheses. The survey will provide information on enrollees’ satisfaction with their choice of plan, the care they receive, the premium amounts, the accessibility of care and the quality of care. The survey will also be a basis for self-reported health status and health risk behavior data as well as utilization data. A stratified random sample of enrollees will be selected to ensure geographic and demographic representation. Consideration will be given to whether it will be necessary to conduct this survey at least twice, once as a baseline and at least once as follow-up. • Interviews - To obtain information on employers’ response to BadgerCare it will be necessary to contact employers through either a survey or an interview method or both. The favored approach will be to survey a sample of employers and, based on the survey results, select a small number for in-depth interviews. • HMO Histories - Enrollee and service specific data will be generated for all BadgerCare enrollees. These data will form the basis for special studies and auditing individual recipients. Quality of care and access issues will be addressed using these data as a sampling frame. The data received through the ongoing Medicaid Managed Care Quality Improvement Program will serve as the source for such data. • Special reports - Special ad hoc reports will be designed based on claims or aggregate HMO reporting. These reports can be used to monitor BadgerCare performance on various utilization and health status measures. Sentinel indicators will be identified and included in these reports.

WISCONSIN

Effective Date:

Approval Date: 63