§ 74.09.480. Performance measures -- Provider rate increases -- Report
(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, parents, and other purchasers, shall identify explicit performance measures that indicate that a child has an established and effective medical home, such as:
(a) Childhood immunization rates;
(b) Well child care utilization rates, including the use of validated, structured developmental assessment tools that include behavioral and oral health screening;
(c) Care management for children with chronic illnesses;
(d) Emergency room utilization; and
(e) Preventive oral health service utilization.
Performance measures and targets for each performance measure must be reported to the appropriate committees of the senate and house of representatives by December 1, 2007.
(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 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 in both fee for service and managed care.
(3) The department shall provide an annual report to the governor and the legislature related to provider performance on these measures, beginning in September 2010 and annually thereafter.
[2007 c 5 § 4.]
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