(1) The department, in collaboration with the
department of health, health carriers, local public health
jurisdictions, children's health care providers including
pediatricians, family practitioners, and pediatric
subspecialists, community and migrant health centers, parents,
and other purchasers, shall establish a concise set of explicit
performance measures that can indicate whether children enrolled
in the program are receiving health care through an established
and effective medical home, and whether the overall health of
enrolled children is improving. Such indicators may include, but
are not limited to:
(a) Childhood immunization rates;
(b) Well child care utilization rates, including the use of
behavioral and oral health screening, and validated, structured
developmental screens using tools, that are consistent with
nationally accepted pediatric guidelines and recommended
administration schedule, once funding is specifically
appropriated for this purpose;
(c) Care management for children with chronic illnesses;
(d) Emergency room utilization;
(e) Visual acuity and eye health;
(f) Preventive oral health service utilization; and
(g) Children's mental health status. In defining these
measures the department shall be guided by the measures provided
in RCW 71.36.025.
Performance measures and targets for each performance
measure must be established and monitored each biennium, with a
goal of achieving measurable, improved health outcomes for the
children of Washington state each biennium.
(2) Beginning in calendar year 2009, targeted provider rate
increases shall be linked to quality improvement measures
established under this section. The department, in conjunction
with those groups identified in subsection (1) of this section,
shall develop parameters for determining criteria for increased
payment, alternative payment methodologies, or other incentives
for those practices and health plans that incorporate
evidence-based practice and improve and achieve sustained
improvement with respect to the measures.
(3) The department shall provide a report to the governor
and the legislature related to provider performance on these
measures, beginning in September 2010 for 2007 through 2009 and
biennially thereafter. The department shall advise the
legislature as to its progress towards developing this biennial
reporting system by September 30, 2009.
[2009 c 463 § 4; 2007 c 5 § 4.]
NOTES:
Findings -- Intent -- Short title -- 2009 c 463: See notes following RCW 74.09.470.