INSTRUCTION SHEET – MASTER- RESIDENTIAL ONLY
PROVIDER PERFORMANCE MEASURES
DATA COLLECTION AND REPORTING INSTRUCTIONS
January 28, 2015
The following information will guide you in collecting and reporting data on performance measures
included in your current contract. All providers will be scored on the claims denial rate measure but are
not required to report on it; CenterPoint Human Services (CenterPoint) is able to capture this information
from paid claims data and will report it back to you monthly so you can track your own progress.
Providers who deliver mental health, intellectual/developmental disabilities and substance abuse services
(all disability service types) are responsible for reporting on the measures listed below.
Please indicate only numbers on the reporting template. Do not add symbols (eg %). Please copy and save
your reporting template to allow you to enter the following quarters’ data on the same template for
submission. If your template becomes corrupted for any reason, you may access a clean copy on the
CenterPoint website at www. cphs.org. See below for instructions if you have not served any CenterPoint
clients in a given quarter.
You may use your own process for data collection or opt to use the Excel workbook “tracker” provided
by CenterPoint (it automatically calculates outcomes as you enter data). Do not submit the tracker to
CenterPoint; it is for your internal use only. If you use the “tracker” to calculate quarterly data, move new
client referrals with less than 14 calendar days available for service to the next reporting quarter.
Providers will receive a performance score based on results of the required outcome measures. Fiscal
outcome measures count 15% of the total score. The remaining measures count 85% of the total score.
Scores are weighted to provide focus on the most critical areas.
Timely reporting will be appreciated and expected (see table at the end of the document). Failure to
submit reports on or before the expected due date may result in a Plan of Correction. A pattern of failure
to submit in a timely manner will have contract implications.
EXCLUDED from reporting:
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Hospitals, ICFs, PRTFs, and MDs (prescribers) in solo or MD (prescriber) group practices only;
Solo and group practices that serve 24 or fewer clients. When the 25th client is served (defined as
a billable event), the reporting template must be completed and submitted quarterly for the
remainder of the contract year. If a solo or group practice serves 24 or less clients an email
attesting to that fact must be submitted quarterly to ProviderOutcomes@cphs.org.
Agencies that serve 3 or fewer clients. When the 4th client is served (defined as a billable event),
the reporting template must be completed and submitted quarterly for the remainder of the
contract year. If an agency serves 3 or fewer clients for the quarter an email attesting to that
fact must be submitted quarterly to ProviderOutcomes@cphs.org .
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FISCAL PERFORMANCE MEASURE
1. Outcome: Provider denial rate on claims at or below 10% (data collected/tracked by
CenterPoint)
Data source: CenterPoint claims and billing data
Data reported: N/A. It is not necessary for providers to report to CenterPoint on this measure; we
are able to capture the data based on paid claims.
Open Access MH/SA/I-DD providers are responsible for reporting on the following performance
measures found in your current contract with CenterPoint. Please use the reporting template provided and
report according to the schedule located at the end of this document.
FISCAL PERFORMANCE MEASURES
2. Outcome: Days of cash on hand – Minimum of 60 days
Definition: The days of cash on hand ratio measures the number of days of average cash expenses that a
business maintains in cash and cash equivalents. High values for this ratio usually imply a greater ability
to meet short term obligations.
Data source: Financial statements
Data reported: Total number of days of cash on hand; 60 days = Met
Calculation: Cash + Cash Equivalents / (Total Expenditures / Number of days being measured)
2a. Outcome: Current ratio of 1.0- ONLY reported if Days of Cash on Hand is less than 60 days
(indicate na on the reporting template if #1 is met)
Definition: The current ratio is used to measure liquidity. The value of the current ratio measures the
number of dollars held in current assets per each dollar of current liabilities. High values for this imply
good ability to pay short–term obligations.
Data source: Financial statements
Data reported: Ratio; 1.0 =Met
Calculation: Current assets / Current liabilities
2b. Outcome: Long-term debt to net assets ratio – Maximum ratio of 2.5:1- ONLY reported if Days
of Cash on Hand is less than 60 days (indicate na on the reporting template if #1 is met)
Definition: The long term debt to net assets ratio is used to measure the company’s assets that are
financed with loans and financial obligations lasting more than one year. The ratio provides a general
measure of the financial position of the company, including its ability to meet financial requirements for
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outstanding loans. A year-over-year decrease in this metric would suggest the company is progressively
becoming less dependent on debt to grow their business.
Data source: Financial statements
Data reported: Ratio; 2.5:1 = Met
Calculation: Long term debt / Total Net Assets
CLINICAL PERFORMANCE MEASURE
3. Outcome: Integration of Care – Annual Primary Care Physician (PCP) visit.
NOTE: Reporting required for Medicaid-funded clients only; all disability groups; limited to
clients receiving Enhanced Benefits.
Definition: Evidence of at least one visit to a PCP within the previous 12 months at the time of review for
Medicaid clients as defined above.
Data source: Provider peer review forms
Data reported: Percent of Medicaid-funded client charts in compliance; 70% = Met
Calculation: Number of charts indicating annual PCP visit / Total number of charts
reviewed (expressed as a percentage)
REPORTING SCHEDULE
Note: Current CenterPoint Medicaid contract addendums for Calendar Year 15 (CY15) are in effect for
January 1, 2015- June 30, 2015 as DMA will be moving to the Fiscal Year effective July 1, 2015. Current
CenterPoint State funded contracts for Fiscal Year 15 (FY15) are based on a fiscal year that began on July
1, 2014 and are in effect until June 30, 2015. CenterPoint intends to continue reporting requirements on
the current performance measures in contracts offered for FY16 (July 1, 2015- June 30, 2016). At that
time two additional reporting periods will be added to extend reporting through the life of the contract.
To avoid confusion between CY and FY quarters as DMA transitions to the fiscal reporting year, we have
identified Reporting Periods that mimic the traditional quarters in both a calendar year and a fiscal year.
Submit the reporting template to CenterPoint at ProviderOutcomes@cphs.org according to the following
schedule. To simplify data collection, CenterPoint provided a “tracker” that automatically calculates
outcomes as you enter the data. You may use this option or your own process. Please remember that it is
not required that you use the tracker and it is not necessary to submit it to CenterPoint. You only need to
submit the reporting template type that applies to your practice.
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Reporting Period
Reporting Period 1
Reporting Period 2
Reporting Period 3
Reporting Period 4
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DUE DATE
April 30, 2015
July 30, 2015
October 30, 2015
January 30, 2016
REPORTING PERIOD
January - March 2015
April – June 2015
July – September 2015
October – December 2015