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Area 2: Getting Results - Evaluating the Program

Award Criteria » Application Guidelines and Evaluation Criteria for Health Plans » Area 2: Getting Results - Evaluating the Program

Describe how you capture and evaluate outcomes, and include the results you have achieved.

Area 2: Getting Results – Evaluating the Program (15 points)

Application GuidelinesEvaluation Criteria
  • Discuss the measures your program tracks, including process measures, health outcome measures and costs.
  • Describe how you track asthma patients (e.g., through an asthma registry, electronic medical records or other system to collect and analyze information on patient diagnoses, treatments, referrals, interventions, health care utilization and outcomes.
  • If you have data specific to the effectiveness of in-home interventions, include this information.
  • Describe the results you can attribute to your environmental asthma management activities.
  • Program tracks process measures (e.g., appropriate use of asthma medications, primary and specialty care visit rates).
  • Program tracks health outcome measures, such as reduced hospitalizations and ER visits, improved quality of life and symptom-free days.
  • Processes and procedures are incorporated into the program’s design to ensure that evaluation (i.e., data collection and analysis) is a routine part of the asthma program.
    • Example:"LA Cares About Asthma® annually measures HEDIS data on the Use of Appropriate Medications for People with Asthma and analyzes the data in comparison to previous years. Reports are generated by geographic region, age of members and asthma severity level. The ADM registry is used to track members on a monthly basis. Monthly reports including new members, current members and stratification changes are generated from the ADM to facilitate member interventions."
  • Program management includes analysis of costs or return on investment.
    • Example:"On average, participants had a savings of $3,833 per participant ($319 PMPM)."
  • Program has achieved cost savings or positive return on investment compared to a baseline measurement.
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