Attachment 1 - Performance Measure Goals.pdf

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Attached to
State Health Insurance Information, Counseling, and Assistance Services
Solicitation number
300000269999346
Issued by
Missouri

About this file

This is a Performance Measure Goals document prepared for the Missouri Department of Commerce and Insurance in connection with state health insurance information, counseling, and assistance services funded by the Administration for Community Living (ACL). The document establishes five key performance measures that define expected service delivery outcomes for the contract period ending in 2025. These measures encompass counseling contacts delivered through in-person, telephone, and electronic means, with a goal of 49,963 contacts; outreach contacts through presentations and health/senior fairs, targeting 91,382 persons; contacts with Medicare beneficiaries under age 65 including disabled populations, with a goal of 7,536 contacts; hard-to-reach populations including low-income individuals at or below 150% of federal poverty level, rural county residents, and non-native English speakers over 65, targeting 63,611 contacts; and enrollment contacts for qualifying Medicare and Medicaid-related topics, with a goal of 36,372 unduplicated contacts.

All performance measures are evaluated using a Likert scale rating system with acceptable performance standards set at "Average," "Good," or "Excellent" levels. The performance measures are based on a total population estimate of 1,294,367 individuals, with specific sub-populations identified for targeted outreach including 184,251 Medicare beneficiaries under 65 and 827,190 hard-to-reach individuals meeting designated criteria. These goals establish the contractual expectations for service delivery and quality standards that must be met throughout the contract term.

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Text version

Performance Measures Goals as Prescribed by ACL

Measure Description Population Estimate

Example Goal/ACL 2025 (Most Recent #)

Likert Ratings

Performance Measure 1:

Counseling Contacts

Counseling contacts will include in- person, telephone, and contacts by e-mail, postal or fax.

1,294,367 49,963 Average, Good or Excellent

Performance Measure 2:

Outreach Contacts

Persons reached through presentations, booths/exhibits at health/senior fairs and enrollment events.

1,294,367 91,382 Average, Good or Excellent

Performance Measure 3:

Beneficiaries Under 65

Contacts with Medicare beneficiaries under the age of 65 which includes disabled population.

184,251 7,536 Average, Good or Excellent

Performance Measure 4: • Low-income at or below 150% of federal poverty level,

• Rural counties, and

• Non-native English speaking contacts (over 65)

827,190 63,611 Average, Good or Excellent

Hard-to-Reach Contacts

Performance Measure 5:

Enrollment Contacts

Unduplicated enrollment contacts with one or more qualifying enrollment topic including:

• Part D: eligibility/screening, plan comparison, plan enrollment, plan non- renewal

• LIS and MSP: eligibility/screening, application assistance,

• Medicaid: screening and application assistance

• Medicare Part A&B: benefit explanation, plan non-renewal

• Medigap supplement: eligibility/screening and plan comparison

• Medicare Advantage: eligibility/screening, plan comparison, plan enrollment/disenrollment, plan non-renewal

1,294,367 36,372 Average, Good or Excellent

STATE 0000000530SL

Attachment 1

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