Healthy Louisiana Reporting

Report Information

Document ID:136

Document Name:QAPI Program Description, Work Plan, Impact and Effectiveness of Program Evaluation

Revision Date: 12/13/2017

Reporting Frequency:Annually

Deliverable Type: Text Document

Report Due Date:March 31

Subject Matter:Quality

Document Type: Free FormTemplate

Information to be completed by the Health Plan

Health Plan ID:[Health Plan ID]

Health Plan Name:[Health Plan Name]

Health Plan Contact:[Contact Person's Name]

Health Plan Contact Email:[Contact Email]

Report Period Start Date:[Start Date]

Report Period End Date: [End Date]

Date Completed: [Today's Date]

(This plan can be submitted in any format. However, this document must be completed and submitted with the required plan)

Definitions and Instructions:

QAPI Work Plan

The QAPI Committee shall develop and implement a written QAPI plan which incorporates the strategic division provided by the governing body. The QAPI plan shall be submitted to DHH for written approval within thirty (30) date the Contract is signed, annually thereafter, and prior to revisions. The QAPI plan shall:

  • Reflect a coordinated strategy to implement the QAPI Program, including planning, decision making, intervention and assessment of results;
  • Include processes to evaluate the impact and effectiveness of the QAPI Program;
  • Include a description of the Health Plan staff assigned to the QAPI Program, their specific training, how they are organized, and their responsibilities; and
  • Describe the role of its providers in giving input to the QAPI Program.
  • Describe the methods for ensuring data collected and reported to DHH is valid, accurate, and reflects providers’ adherence to clinical practice guidelines, as appropriate.
  • Include a fidelity monitoring plan which at a minimum includes the fidelity criteria for each applicable service/provider type, sampling approach, data collection methods, tools to be used, frequency of review, and validation methods.

QAPI Impact and Effectiveness of QAPI Program Evaluation

Report an evaluation of the impact and effectiveness of the QAPI program to DHH annually.

The evaluation must include but is not limited to the following:

  • A description of the ongoing and completed QAPI activities pertaining to the behavioral health populates performance measure results, including a summary to explain performance below the threshold/goal and trend analysis.
  • Must include an ongoing program that shows measureable improvement.
  • Did the program measure, analyze and track the performance measures and other aspects of performance?
  • Evidence of the use of appropriate data with ongoing monitoring of the effectiveness and safety of services and quality of care.
  • Opportunities for improvement are clearly identified with appropriate corrective action plans implemented.
  • QAPI activities were prioritized and focused based on high risk, high volume, and problem prone population.
  • Performance Improvement project includes: what PIP was conducted, reason for conducting the project, and the measurement.

RFP Reference: QAPI Work Plan and QAPI Committee Responsibilities