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Data from the utilization survey requirement described in Addendum IV will provide indications of health care utilization in key preventive health areas within the HMOs. Important indicators we will use include the following: rates of HealthCheck (EPSDT) services, rates of PAP testing, rates of ambulatory follow-up for recipients discharged from a hospital with mental health or AODA diagnoses, rates of hospitalization for recipients with asthma, rates of primary care provider visits, and rates of preventive dental care.

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 child care 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: Please see response to # 9.3.6.

9.3.8 Performance measures for special targeted populations.

9.4

The state assures it will collect all data, maintain records and furnish reports to the Secretary at the times and in the standardized format that the Secretary requires. (Section 2107(b)(1)) (42 CFR 457.720)

9.5

The state assures it will comply with the annual assessment and evaluation required under Section 10. Briefly describe the states plan for these annual assessments and reports. (Section 2107(b)(2)) (42 CFR 457.750)

The data sources and analysis plan described in the response to Question 9.3 will provide the information necessary to prepare these reports.

In addition, to obtain information about children without creditable coverage, we will rely on the Wisconsin Family Health Survey, which was discussed extensively in Section 2.1. As indicated in section 2.1, the survey was started in 1989 to collect information on the health status, health problems, health insurance coverage, and use of health care services among Wisconsin residents. The survey will create the baseline data on children without creditable coverage sufficient to provide the information requested in the table to Section 10.1.

WISCONSIN

Effective Date:

Approval Date: 65