Disclaimer of use: Do not duplicate, publish, modify or ... · 5 View Point Health Scorecard Type Staff Title Quarter Run Date Performance Targets Scoring System Access Staff Metric

Disclaimer of use: Do not duplicate, publish, modify or otherwise distribute the material in this guide unless specifically authorized by View Point Health to do so. This guide

is the property of View Point Health and is protected by copyright laws. Revised 9/2017

2

Contents Access Staff .............................................................................................................................................................................................................................................. 5

ACT Clinician ............................................................................................................................................................................................................................................. 6

Billing Staff ............................................................................................................................................................................................................................................... 7

Clubhouse Clinician .................................................................................................................................................................................................................................. 8

Clubhouse Staff / Center Director ............................................................................................................................................................................................................ 9

Day Services Clerical / Center Director / Program Manager ................................................................................................................................................................. 10

Day Services Case Manager ................................................................................................................................................................................................................... 11

Developmental Disabilities Professional (DDP) Staff ............................................................................................................................................................................. 12

Developmental Disabilities Residential Program Manager ................................................................................................................................................................... 13

Developmental Disabilities Residential Site Supervisor ......................................................................................................................................................................... 14

Developmental Disabilities Residential Staff / Program Coordinator ................................................................................................................................................... 15

GRAN Center Director ............................................................................................................................................................................................................................ 16

GRAN Clinical Staff ................................................................................................................................................................................................................................. 17

GRAN Support Staff ................................................................................................................................................................................................................................ 18

ICM Program Manager ........................................................................................................................................................................................................................... 19

ICM Clinician .......................................................................................................................................................................................................................................... 20

Independent Enterprises CAI Staff ......................................................................................................................................................................................................... 21

Independent Enterprises Clerical Staff .................................................................................................................................................................................................. 22

Independent Enterprises Program Manager ......................................................................................................................................................................................... 23

Independent Enterprises Supervisor, Instructor, CAI Staff .................................................................................................................................................................... 24

Nurse Practitioner .................................................................................................................................................................................................................................. 25

Outpatient Engagement Specialist......................................................................................................................................................................................................... 26

Outpatient Center Director .................................................................................................................................................................................................................... 27

Outpatient Center Director – Substance Abuse .................................................................................................................................................................................... 28

Outpatient Clinician / Clinician Supervisor ............................................................................................................................................................................................ 29

3

Outpatient CSS ....................................................................................................................................................................................................................................... 30

Outpatient Front Office.......................................................................................................................................................................................................................... 31

Outpatient Intake Clinician / Supervisor ................................................................................................................................................................................................ 32

Outpatient Nursing Administrator ......................................................................................................................................................................................................... 33

Outpatient Nurse / Nursing Supervisor ................................................................................................................................................................................................. 34

Outpatient Program Manager ............................................................................................................................................................................................................... 35

Prescriber ............................................................................................................................................................................................................................................... 36

Rehab Services Case Management (CSS) Clinician ................................................................................................................................................................................ 37

Rehab Services Intake Clinician .............................................................................................................................................................................................................. 38

Rehab Services Program Manager ......................................................................................................................................................................................................... 39

Metrics Supplemental Guidance ........................................................................................................................................................................................................... 40

ACT Team - Minimum Monthly Contacts (ACTMINCON) ................................................................................................................................................................... 41

Average Daily Attendance (ADATAR) ................................................................................................................................................................................................. 41

Average Documentation Signed Within 24 Hours (AVGDOC24) ....................................................................................................................................................... 41

Billed Hours (BH) ................................................................................................................................................................................................................................ 42

Billed Ratio (BR).................................................................................................................................................................................................................................. 43

Clients Attending Follow-Up (CFUP) .................................................................................................................................................................................................. 43

Clients Served By Caseload ................................................................................................................................................................................................................ 44

Clients Served By Center (CSCTR) ...................................................................................................................................................................................................... 44

Clients Served Per Month (CSMTH) ................................................................................................................................................................................................... 44

CSS Minimum Monthly Contacts (MINCON) ...................................................................................................................................................................................... 44

Documentation Signed by End of Shift (DOCEOS) ............................................................................................................................................................................. 45

Documentation Signed Within 24 Hours (DOC24) ............................................................................................................................................................................. 45

ICM Team - Minimum Monthly Contacts (ICMMINCON) .................................................................................................................................................................. 46

Staff Meeting Target (MTGTAR) ......................................................................................................................................................................................................... 46

Productivity (PROD) ........................................................................................................................................................................................................................... 47

4

5

View Point Health Scorecard Type Staff Title

Quarter

Run Date

Performance Targets Scoring System Access Staff

Metric Base Actual Quality Measure Floor Tier Score

KPI 2.1 – GCAL Avg Days to Scheduled Appointment (All Outpatient Centers)

Average Days

KPI 3.1 – Hospital Discharge to Tx Appointment (All Outpatient Centers)

Hospital Discharges Scheduled Tx Appointments within 7 Days

Actual / Base = ___%

KPI 3.2 – Hospital Discharge to MD Appointment (All Outpatient Centers)

Hospital Discharges Scheduled MD Appointments within 14 Days


STAR Rating Average Rating

Incentive Levels

Score Min Score Max Incentive

Total:

Have all target floors been met?

Incentive based on score:

The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

6


Quarter

Run Date

Performance Targets Scoring System ACT Clinician


Billed Ratio Locked months results

Open months results Current Quarter results

Billable services provided by center

Services which successfully billed


Documentation within 24 Hours

Appointments with documentation

Documents signed within 24 hours


Team Min Mthly Contacts ACT

July results August results

September results Current Quarter Results

Number of ACT clients for each

month

Number of ACT clients receiving

the minimum number of contacts

for each month

% Qualified Actual / Base = ___%

Peer Review Score

Responses Considered

(number of questions x number of reviews)

Marked “Full Compliance” (score of 2)

% “Full Compliance”

Incentive Levels


For data tracking purposes only, no incentives available

Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

7


Quarter

Run Date

Performance Targets Scoring System Billing Staff


Accounts Receivable Kept Timely (Aging Report)

Collectable Balance Amount collected

on time Actual / Base = %

Applied Cash Kept Current (Unapplied Report)

Unapplied Amount Unapplied amount with justification

Actual / Base = %

Insurance Billed vs Collected (ABCD Report)

Total FYTD Billed Amount

Total FYTD Cash Collected

Actual / Base = %

KPI 9.5 Medicaid Billed within 90 Days

Medicaid Claims during Quarter, excluding failed

claims

Medicaid claims billed within 90

days Actual / Base = %


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

8


Quarter

Run Date

Performance Targets Scoring System Clubhouse Clinician


Contract Requirements Number of

contract requirements

Number of contract

requirements that were met


Contract Dollars Invoiced Per Month

Total contract dollars invoiced

/ # months in reporting period

Documentation within 24 Hours

Appointments with

documentation

Documents signed within 24

hours



Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

9


Quarter

Run Date

Performance Targets Scoring System Clubhouse Staff / Center Director


Contract Requirements Number of

contract requirements

Number of contract

requirements that were met


Clients Served Per Month Sum of clients served in reporting period

/ # of months within reporting period

Contract Dollars Invoiced Per Month

Total contract dollars invoiced

/ # months in reporting period


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

10


Quarter

Run Date

Performance Targets Scoring System Day Services Clerical / Center Director / Program Manager







ADA Quarter Target Number of clients

attending services for the reporting period

Number of days in reporting period

Total Attendance / Day = __ AVG Attendance

Peer Review Score Responses Considered (number of questions x

number of reviews)




Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

11


Quarter

Run Date

Performance Targets Scoring System Day Services Case Manager







Documentation within 24 Hours Appointments with

documentation Documents signed

within 24 hours Actual / Base = ___%

ADA Quarter Target Number of clients

attending services for the reporting period

Number of days in reporting period

Total Attendance / Day = __ AVG Attendance


number of reviews)




Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

12


Quarter

Run Date

Performance Targets Scoring System Developmental Disabilities Professional (DDP) Staff


Support Coordination Rating

Total Ratings “1” Ratings Actual / Base = ___%

Peer Review Score




Actual / Base = % “Full Compliance”


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

13


Quarter

Run Date

Performance Targets Scoring System Developmental Disabilities Residential Program Manager


Staff Avg Documentation (End of Shift)

Average of the scores for all staff assigned to a

center with this metric.



Residential Meaningful Outings

Average Outings for Managed Houses

Peer Review Score






Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

th

e metrics w

ere met o

r exceeded

.

14


Quarter

Run Date

Performance Targets Scoring System Developmental Disabilities Residential Site Supervisor


Documentation Signed by End of Shift

Number of activities requiring

documentation

Number of Activities signed by

11:59 of service date





Average Outings for Supervised House

Peer Review Score






Incentive Levels


Total:



The flo

or valu

es are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

th

e metrics w

ere met o

r exceeded

.

15


Quarter

Run Date

Performance Targets Scoring System Developmental Disabilities Residential Staff / Program Coordinator



# Meaningful Outings for House



Peer Review Score






Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

16


Quarter

Run Date

Performance Targets Scoring System GRAN Center Director







Center margin % Margin (derived from the

business office)

% Clients d/c Level 3 Number of discharged

clients Clients discharged

at level 3 Actual / Base = ___% d/c level 3


number of reviews)




Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts

of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d

are sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

17


Quarter

Run Date

Performance Targets Scoring System GRAN Clinical Staff














number of reviews)




Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

18


Quarter

Run Date

Performance Targets Scoring System GRAN Support Staff











number of reviews)




Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the

tiers, and

are sum

med

to d

eterm

ine th

e in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

19


Quarter

Run Date

Performance Targets Scoring System ICM Program Manager


% Staff meeting target Number of supervised

staff

Number of supervised staff meeting billed hours target

Actual / Base = ___% Staff Who Met Target

Staff average documentation w/in 24 hr

Average of the scores for all staff

assigned to a center with this metric.

Staff Quality Audit Score Average number of

points possible Average number

of points achieved Actual / Base = ___ AVG % scored

Team Min Mthly Contacts ICM July results

August results September results

Current Quarter Results

Number of ICM clients for each month

Number of ICM clients receiving

the minimum number of

contacts for each month



Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

20


Quarter

Run Date

Performance Targets Scoring System ICM Clinician


Billed Hours Month 1 Results Month 2 Results Month 3 Results

Current Quarter results

Available work hours during

month

Hours billed during month

Actual / Base = ___% Billed


documentation Documents signed within

24 hours Actual / Base = ___%

Quality Audit Score Number of points

possible Number of points achieved Actual / Base = ___ % Scored

Team Min Mthly Contacts ICM July results

August results September results

Current Quarter Results

Number of ICM clients for each

month

Number of ICM clients receiving the minimum number of contacts for

each month



Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of

meetin

g the m

etrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d

are sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

21


Quarter

Run Date

Performance Targets Scoring System Independent Enterprises CAI Staff





month



Documentation signed by end of shift


Documents signed by end of shift


IE Meaningful Outings # Meaningful Outings

Support Coordination Rating Total Ratings “1” Ratings Actual / Base = ___%

Peer Review Score

Responses Considered (number of questions x

number of reviews)




Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts

of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

22


Quarter

Run Date

Performance Targets Scoring System Independent Enterprises Clerical Staff





Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

23


Quarter

Run Date

Performance Targets Scoring System Independent Enterprises Program Manager










Peer Review Score






Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

req

uirem

ents o

f meetin

g the m

etrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

th

e metrics w

ere met o

r exceeded

.

24


Quarter

Run Date

Performance Targets Scoring System Independent Enterprises Supervisor, Instructor, CAI Staff


Documentation signed by end of shift


Documents signed by end of shift





Peer Review Score






Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers,

and

are sum

med

to d

etermin

e the in

cen

tive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics were m

et or exceed

ed.

25


Quarter

Run Date

Performance Targets Scoring System Nurse Practitioner





month



Notes w/in 24 hours ratio Appointments with

notes Number notes signed

within 24 hours Actual / Base = ___% Notes

signed w/in 24 hours


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of

meetin

g the m

etrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d are

sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics

were m

et or exceed

ed.

26


Quarter

Run Date

Performance Targets Scoring System Outpatient Engagement Specialist







Clients served by center Caseload count for all staff

members in the center Caseload count with activity for all staff members in the center?

Actual / Base = ___% Served

KPI 2.2 (GCAL Outreaches) GCAL DNS Appointments DNS Appointments with

Outreach in 24 Hours Actual / Base =

___%

KPI 3.2 (Hospital Discharge to MD Appointment)

Hospital Discharges Hospital Discharges to MD

Appointment within 14 Days Actual / Base =

___%


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of

meetin

g the m

etrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d are

sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the m

etrics

were m

et or exceed

ed.

27


Quarter

Run Date

Performance Targets Scoring System Outpatient Center Director







Staff average documentation w/in 24 hr Average of the scores for all staff


KPI 1.1 (Days to Intake) Average Days

KPI 1.2 (Days Intake to Treatment Appointment)

Average Days

KPI 1.3 (Days Intake to MD Appointment) Average Days


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts

of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d

are sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

28


Quarter

Run Date

Performance Targets Scoring System Outpatient Center Director – Substance Abuse


% Staff Meeting BH Target # Staff # Staff Meeting Target Actual / Base = ___%

Staff average documentation w/in 24 hr Average of the scores for all staff


KPI 5.2 – SA Clients Receiving Groups # Active SA Clients # SA clients receiving 5

or more groups Actual / Base = ___%


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts

of m

eeting th

e metrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d

are sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

29


Quarter

Run Date

Performance Targets Scoring System Outpatient Clinician / Clinician Supervisor




Available work hours during month







possible Number of points

achieved Actual / Base = ___ % Scored

Clients served by caseload Number of clients on

caseload Clients with activity

during reporting period Actual / Base = ___ % Served


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of

meetin

g the m

etrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d are

sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

30


Quarter

Run Date

Performance Targets Scoring System Outpatient CSS













Minimum monthly contacts Floor contacts Actual minimum

contacts Actual / Base = ___% Minimum

Contacts


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of

meetin

g the m

etrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d are

sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

31


Quarter

Run Date

Performance Targets Scoring System Outpatient Front Office







KPI 2.2 (GCAL Outreaches) GCAL DNS

Appointments DNS Appointments with

Outreach in 24 Hours Actual / Base = ___%

KPI 3.2 (Hospital Discharge to MD Appointment)

Hospital Discharges Hospital Discharges to

MD Appointment within 14 Days



Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of

meetin

g the m

etrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d

are sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

32


Quarter

Run Date

Performance Targets Scoring System Outpatient Intake Clinician / Supervisor













% Clients attending follow-up Number of intakes? Number of follow-ups? Actual / Base = ___% Clients w/

follow-ups


Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of

meetin

g the m

etrics.

The sco

re values are d

etermin

ed b

y the tiers, an

d are

sum

med

to d

eterm

ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

33


Quarter

Run Date

Performance Targets Scoring System Outpatient Nursing Administrator










Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of

meetin

g the m

etrics.

The sco

re values are d

etermin

ed b

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ine th

e ince

ntive.

The tier valu

es ind

icate th

e level to w

hich

the

metrics w

ere met o

r exceeded

.

34


Quarter

Run Date

Performance Targets Scoring System Outpatient Nurse / Nursing Supervisor














Incentive Levels


Total:



The

floo

r value

s are the m

inim

um

requ

iremen

ts of

meetin

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etrics.

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ntive.

The tier valu

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hich

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ere met o

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.

35


Quarter

Run Date

Performance Targets Scoring System Outpatient Program Manager








staff Number of supervised staff meeting billed hours target





KPI 1.2 (Days Intake to Treatment Appointment)

Average Days


Incentive Levels


Total:



The

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s are the m

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.

36


Quarter

Run Date

Performance Targets Scoring System Prescriber


Notes w/in 24 hours ratio Appointments with

notes Number notes signed

within 24 hours Actual / Base = ___% Notes

signed w/in 24 hours



Billing target for each month

Summed billing amount in the claims record for

each month Actual / Base = ___% Billed


Incentive Levels


Total:



The

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of m

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tive.

The tier valu

es ind

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hich

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metrics w

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.

37


Quarter

Run Date

Performance Targets Scoring System Rehab Services Case Management (CSS) Clinician













Minimum monthly contacts Floor contacts Actual minimum

contacts Actual / Base = ___% Minimum

Contacts


Incentive Levels


Total:



The

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metrics w

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.

38


Quarter

Run Date

Performance Targets Scoring System Rehab Services Intake Clinician













% Clients attending follow-up Number of intakes? Number of follow-ups? Actual / Base = ___% Clients w/

follow-ups


Incentive Levels


Total:



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hich

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metrics w

ere met o

r exceeded

.

39


Quarter

Run Date

Performance Targets Scoring System Rehab Services Program Manager








staff Number of supervised staff meeting billed hours target





Staff Quality Audit Score Average number of

points possible Average number of points

achieved Actual / Base = ___ AVG % scored


Incentive Levels


Total:



The

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.

40

Metrics Supplemental

Guidance

41

ACT Team - Minimum Monthly Contacts (ACTMINCON)

This metric is a comparison of total qualified contacts to the total floor contacts. This is a team metric – all staff with this metric receive the same score. The data is gathered for each month of the reporting period separately. The clients included are those who are enrolled in the ACT program for the entire month and have at least 1 kept appointment that is an ACT service within the month.

ACT services are defined as the following activity codes: ACTGRP, ACTIC, ACTNB, ACTOC, ACTTM

Med Maint clients are excluded from this metric. Clients are then determined to be “qualified” or “unqualified.” A qualified client has at least 12 ACT services performed during the month.

% Qualified = Total Qualified ACT Clients / Total ACT Clients (calculated for each month) The monthly results are summed and the metric is calculated for the full quarter.

Average Daily Attendance (ADATAR)

This is the average rate of clients in attendance per work day. The appointments considered for this metric are selected by the following rules:

The date of service was within the reporting period.

The activity status was kept

The organization is NewRock or Beacon Place/Five Points

The program is Peer Support or PSR These appointments are summarized down to create a record for each center, stating the total number of clients in attendance for the entire reporting period, and the total number of days with significant client counts. ** Days where the client count is less than ten are not considered, to account for cases of weekends or holidays where a small amount of clients were seen. The “Total number of clients in attendance” is divided by the total number of workdays, to establish the average daily attendance. This is a shared metric, and each staff member within a center receives the same score.

Average Documentation Signed Within 24 Hours (AVGDOC24)

This metric is a simple average of the DOC24 values for all staff members being supervised by a program manager OR assigned to a given center.

Program Manager: If the staff person being evaluated is a program manager, then this is an analysis of the staff assigned to them. If an assigned staff is

in their grace period and earned a tier, they are included. If an assigned staff is in their grace period and did not earn a tier, they are not included. If an

assigned staff was end dated before the last date of the quarter, they are not included.

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Center Director: If the staff person being evaluated is a center director, then this is an analysis of the staff assigned to the center(s) they are responsible

for. If an assigned staff is in their grace period and earned a tier, they are included. If an assigned staff is in their grace period and did not earn a tier,

they are not included. If an assigned staff was end dated before the last date of the quarter, they are not included.

“Staff Count” is the total count of staff (either under the Program Manager or Center Director) who have the DOC24 metric.

Average Documentation is the percentage of documents that were signed within 24 hours, only for the included staff as described above.

Billed Hours (BH)

This is the measure of the number of hours available for work, vs. the number of hours a staff member actually applied towards billed activities. Calculation: Hours are broken out for the three months of the quarter, with the aggregate totals being used for calculation of the “billed hours” percentage.

Hours Billed: This value is a staff member’s sum of hours from individual appointments and group sessions, wherein... o A signed document exists o The activity was kept o The activity was billed (there is an approval date in the associated claim record.) o The activity was after the initial 90-day grace period.

For group sessions...

o Co-therapists hours are added in when the corresponding primary therapist record can be found. o Extra credit is added to the actual group duration in order to account for the time needed to complete group paperwork, etc. For groups

of 10 or less clients, extra credit of 30 minutes will be provided, only to the primary therapist. For groups of 11 or more clients, extra credit of 60 minutes will be provided, to be split between co-therapists.

o Group sessions with only one participant are eliminated from consideration. They do not become counted as an individual appointment. (Exception: Lawrenceville Anger Management Group)

Hours Worked - Defined: o Full Time Salaried: 167.33 hours per month o Part Time Salaried: (Standard Wkly Hours x 52 weeks) / 12 months = __ hours per month o Hourly: Actual hours worked per month (from Payroll)

Leave of Absence (FT and PT only)

o Leave of absence is taken into consideration, and does not negatively affect this metric score. o LOA day count is computed for the month, and divided by the number of actual days in the month, to arrive at the LOA factor. Defined

hours worked are reduced by the LOA factor.

Unbillable Hours (Exceptions):

o Defined hours worked are reduced by any unbillable hours (exceptions). This is to account for hours where staff were on assignments that are not associated with billed activities. These assignments include mandatory trainings, meetings, and pre-determined non-billable activities.

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PTO: o Hours for Paid Time Off are submitted as exceptions.

90-day Grace Period: o Newly employed staff or staff changing organizations / staff types will receive a 90-day grace period. The data for the grace period will

display on the scorecard as “Excluded Results.” If Billed Hours floor is met, the data during this period will become “Included,” and allow the opportunity for an earned incentive. If the Billed Hours floor is not met, the data from this period will remain excluded.

Billed Ratio (BR)

This metric is the measure of a center’s billed services vs. billable services. Billed Ratio is calculated on a rolling 12-month basis with the oldest 6 months considered as “Locked.” The locked months match the scorecard values presented when they were last open for re-calculation. The most recent 6 months are considered “Open” and the values are calculated on a month-by-month basis. The quarterly measure is based on a sum-up of the last 12 months of both the “count of billed activities” and the “count of billable activities.” Each staff member being evaluated is awarded their center’s monthly calculated values starting with the month they entered the center, as defined by the staff’s effective date, but with no more than the last 12 months being considered for the current quarterly measure. The latest 6 moths’ values are calculated on a month-by-month basis as per the following business rules:

Included are scheduled activities wherein... o The date of activity falls within the reporting period. o The activity status was kept.

The selected activities are summarized by the center/organization with the following values: o Count of billable services – all scheduled activities designated as “Billable” in the system. o Count of billed services – all kept scheduled activities with an approval date in the associated claim record.

Each staff member being evaluated by this metric is awarded their associated center’s monthly calculated values. The total count of billed services is divided by the total count of billable services to establish the billed ratio quality measure. Note: Billed Ratio detail records are available for this metric.

Clients Attending Follow-Up (CFUP)

This metric is the measure of the number of clients attending follow-ups vs. the total number of intakes. “Total Intakes” is the amount of a staff member’s intake activities within the reporting period. “Total Follow-ups” is the amount of a staff member’s intake activities which also have a follow-up date. The follow-up date must be later than the activity date, and can be after the end of the reporting period. The “Total Follow-Ups” is divided by the “Total Intakes” to establish the Clients Attending Follow-Up quality measure.

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Clients Served By Caseload

This metric is the measure of the amount of clients on a staff member’s caseload who received services. A client’s clinician is considered “Primary” when they are that client’s primary clinician at the beginning and at the end of the reporting period. If the client’s clinician varies from beginning to end of the reporting period, that client does not have a “Primary” clinician. “Caseload” is the total count of clients for each primary clinician (as defined above). “Caseload with Activity” is the total number of clients whose kept, billable service count is greater than or equal to 1 for the reporting period. The “Caseload with Activity” is divided by the “Caseload’ to establish the “Clients Served by Caseload” quality measure.

Clients Served By Center (CSCTR)

This metric is the measure of the percentage of a center’s caseload which had activity during the reporting period. This metric is a shared value among all staff members associated with a center. “Center Caseload” is a sum of the caseload counts for all staff members in the center that have the “Clients Served by Caseload” metric (clinicians, nurses, and Engagement Specialists). “Center Caseload w/ Activity” is a sum of the “Caseload with Activity” counts for all staff members in the center that have the “Clients Served by Caseload” metric. The “Center Caseload with Activity” is divided by the “Center Caseload” to establish the “Clients Served by Center” quality measure.

Clients Served Per Month (CSMTH)

This metric is a monthly average of the amount of clients served at a center, for a selected staff type. “Sum of clients served” is the total number of active clients with a primary client/staff relationship, who had at least one kept appointment during the reporting period. For each center, the “Sum of Clients Served” is divided by the number of months in the reporting period to establish the “Average Clients Served per Month” quality measure. Note: the same average is awarded to every staff member within a center who has this metric on their scorecard.

CSS Minimum Monthly Contacts (MINCON)

This metric is a comparison of total actual minimum to the total floor contacts. The data is gathered for each month of the reporting period separately. The clients included are those where a CSS staff could be determined for the month being processed. Med Maint clients are excluded from this metric. The client/staff relationship found in CareLogic records is used to determine the CSS staff member that each CSS client is attributed to.

If multiple CSS staff are assigned to a client for the month, only the one with the latest assignment date is selected

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This staff member must be assigned to the client at both the first day and the last day of the month to count. Clients who have had a CSS activity within the quarter being processed are included in the calculation. The activity does not need to be kept for the client to be included in the calculation. For each CSS client selected by the highlighted criteria above, the total number of kept CSS activities for each of these clients is calculated, categorized by “Regular Contacts” and “Collateral Contacts”.

“Monthly Minimum Contacts”: If the sum of Collateral Contacts and Regular Contacts is 2 or greater, a value of “2” is assigned. If the sum is less than 2, a value of “0” is assigned. Note: a maximum of 1 Collateral Contact is considered in this calculation.

“Minimum Floor Contacts”: 2 contacts are required for every CSS client selected by the highlighted criteria above. “Monthly Actual Minimum Contacts”: Sum of “Monthly Minimum Contacts” for all clients assigned to the CSS staff. “Total Actual Minimum Contacts” is the sum of the monthly minimum contacts for all clients assigned to each CSS staff. “Total Floor Contacts” is the sum of the monthly floor contacts (2 for every CSS client as described above). The “Total Actual Minimum Contacts” is divided by “Total Floor Contacts” to establish the CSS Minimum Monthly Contacts quality measure.

Documentation Signed by End of Shift (DOCEOS)

This is comparison of the number of documents signed by 4:30pm, to the number of appointments with documentation. Appointments with documentation:

This value is the count of a staff member’s scheduled activities for a reporting period, wherein...

o The status was kept

o The “Document ID” is present Documents signed by end of shift:

This value is the count of those scheduled activities selected by the above criteria, which were signed by 4:30pm of the activity date. Excluded activities: Activities on days identified to be excluded are not considered. These exclusions typically occur for days when VPH experienced significant internet disruption and other unforeseen circumstances. Only activities whose signature time is after 4:30pm of the activity date will be excluded from the count.

Documentation Signed Within 24 Hours (DOC24)

This is comparison of the number of documents signed within 24 hours, to the number of appointments with documentation. Appointments with documentation:

This value is the count of a staff member’s scheduled activities for a reporting period, wherein... o The status was kept o The “Document ID” is present

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Documents signed within 24 hours:

This value is the count of those scheduled activities selected by the above criteria, in the time documentation was first signed, whose time lapse between the start of the activity and the time documentation was signed is equal to or less than 24 hours.

Excluded activities: Activities on days identified to be excluded are not considered. These exclusions typically occur for days when VPH experienced significant internet disruption and other unforeseen circumstances. Only activities whose signature time lapse exceeds 24 hours will be excluded from counting against the staff member.

ICM Team - Minimum Monthly Contacts (ICMMINCON)

This metric is a comparison of total qualified contacts to the total floor contacts. This is a team metric – all staff with this metric receive the same score. The data is gathered for each month of the reporting period separately. The clients included are those who are enrolled in the ICM program for the entire month and have at least 1 kept appointment that is an ICM service within the month.

ICM services are defined as having “T1016” in the first five positions of the activity code. Clients are then determined to be “qualified” or “unqualified.” A qualified client has at least 4 ICM services performed during the month.

% Qualified = Total Qualified ICM Clients / Total ICM Clients (calculated for each month) The monthly results are summed and the metric is calculated for the full quarter.

Staff Meeting Target (MTGTAR)

This metric is a measurement of the staff within a given center, who met the target performance for the “Billed Hours” metric. The only staff included in this metric are those who are assigned to a scorecard that has the “Billed Hours” metric. If staff with this metric are in their grace period and earned a tier, they are included. If a staff with this metrics are in their grace period and did not earn a tier, they are not included. If staff were end dated before the last date of the quarter, they are not included.

Program Manager: If the staff person being evaluated is a program manager, then this is an analysis of the staff assigned to them.

Center Director: If the staff person being evaluated is a center director, then this is an analysis of the staff assigned to the center(s) they are responsible for.

“Staff Count” is the total count of staff (either under the Program Manager or Center Director) who have the billed hours metric.

“Staff Who Met Target” is the number of staff who at least met the “Billed Hours” floor target. “Staff Who Met Target” is divided by “Staff Count” to establish the “Staff Meeting Target” quality measure.

47

Productivity (PROD)

This metric is a comparison of the actual billed dollars to the manually entered billing targets for each physician being measured. The targets are entered by month. This metric is calculated on a rolling 12-month basis with the oldest 6 months considered as “Locked”. The locked months match the scorecard values presented when they were last open for recalculation. The most recent 6 months are considered “Open” and the values are calculated on a month-by-month basis. The quarterly measure is based on a sum-up of the last 12 months of both actual billings and billing targets. An activity’s “Billed Amount” is the sum of the billed amount in the claim records, which are tied to the activity and have an approval date. The “Billed Target” is entered manually by month for each physician. A physician’s sum of the “Billed Amounts” is divided by their sum of “Billed Targets” for the reporting period, to establish the “Productivity” quality

measure.