Page 70

64 95 percent of the commercially enrolled California health maintenance organization population. At present, the only audited child-specific HEDIS measure being collected by CCHRI is the immunization status of two year olds. Until audited measures are available, DHCS will collect unaudited health plan reported information on other HEDIS child and adolescent based measures.

7.1.2.

Performance measurement

POPULATION 2/UNBORN OPTION POPULATION 3/ MCAP POPULATION 4/MCAIP

DHCS evaluates and selects a means to enforce plan performance related to the performance standards. Enforcement can take one of several approaches. These include using either a fiscal (or enrollment) penalty based system in which plans are penalized when DHCS identifies a deficiency, or a performance target based system in which plans agree to put a percentage of their premium at risk if they do not achieve the predetermined performance levels.

POPULATION 1/CCHIP

The volume of children in CCHIP, coupled with the short-term duration of the funding makes it infeasible to set up separate performance measures.

However, the CCHIP projects are modeled consistent with the CHIP Program and the health plans delivering the CCHIP services are the same health plans, and also participate in Medicaid. Thus, the information produced for the CHIP and Medicaid program plans will be reflective of the performance for CCHIP.

7.1.2 (a) CHIPRA Quality Core Set

7.1.2 (b) Other

DHCS External Accountability Set 7.1.3.

Information strategies

POPULATION 2/UNBORN OPTION POPULATION 3/ MCAP POPULATION 4/MCAIP DHCS will use information strategies in line with the Medi-Cal program.