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FY 2020 Annual Performance Plan and Report - Goal 1 Objective 3








  
  
    

  
      



Fiscal Year 2020

Released March, 2019



**Topics on this page:** Goal 1. Objective 3 | Objective 1.3 Table of Related Performance Measures

Goal 1. Objective 3: Improve Americans' access to health care and expand choices of care and service options

Accessing health services involves gaining entry into the health care system, usually through payment; gaining access to diverse options for receiving treatment, services, and products, including physical locations and online options; and having a trusted relationship with a health care provider. Efforts to improve access to care are not limited to physical health care. Improving access to behavioral and oral health care, including through innovative solutions that use health information technology, also is critical, especially for populations experiencing disparities in access. To improve outcomes in this objective, HHS is working to address the high cost of care, lack of availability of services, and lack of culturally competent care.

The Office of the Secretary leads this objective. The following divisions are responsible for implementing programs under this strategic objective: ACL, CMS, HRSA, IHS, IOS, OCR, OGA, and SAMHSA.

Objective 1.3 Table of Related Performance Measures

Track the number of unique individuals who received direct services through Federal Office of Rural Health Policy (FORHP) Outreach grants, subject to the availability of resources (Lead Agency - HRSA; Measure ID - 29.IV.A.3)15



FY 2013
			FY 2014
			FY 2015
			FY 2016
			FY 2017
			FY 2018
			FY 2019
			FY 2020Target
			395,000
			400,000
			400,000
			410,000
			415,000
			420,000
			425,000
			200,000Result
			703,070
			820,176
			837,511
			993,187
			704,700
			10/31/19
			10/31/20
			10/31/21Status
			Target
			Exceeded
			Target
			Exceeded
			Target
			Exceeded
			Target
			Exceeded
			Target
			Exceeded
			Pending
			Pending
			PendingFORHP Outreach grants focus on improving access to care in rural communities through the work of community coalitions and partnerships. These grants often focus on disease prevention and health promotion, but can also support expansion of services such as primary care, mental and behavioral health care, and oral health services. Over 700,000 people received direct services supported through Outreach grants in FY 2017. In FY 2019 and 2020, FORHP will continue to fund non-categorical grants that allow rural communities to respond to health care challenges and issues unique to rural areas.

Improve patient and family engagement by improving shared decision-making (Lead Agency - CMS; Measure ID - MCR31)16



CY 2013
			CY 2014
			CY 2015
			CY 2016
			CY 2017
			CY 2018
			CY 2019
			CY 2020Target
			N/A
			Baseline
			N/A
			N/A
			76%
			Baseline
			TBD
			TBDResult
			N/A
			74.6%
			75.2%
			75.4%
			75.85%
			07/31/19
			07/31/20
			07/31/21Status
			N/A
			Historic Actual
			Historic Actual
			Historic Actual
			Target Not Met but Improved
			Pending
			Pending
			PendingCongress created the Shared Savings Program to facilitate coordination and cooperation among providers to improve the quality of care for Medicare FFS beneficiaries and reduce unnecessary costs. Similarly, Congress designed the Merit-based Incentive Payment System (MIPS) to tie Medicare payments to clinicians to quality and cost efficient care, to drive improvement in care processes and health outcomes, and to increase the use of health care information. The purpose of this performance goal is to help assess an important component of patient experience of care with their provider. Shared decision making between patient, caregiver, and provider is considered to be a fundamental component of a patient-centered health care system that leads to improved health outcomes for patients.

The final results reported are representative of the survey results from the Shared Decision Making Summary Survey Measure (SSM), which is collected and reported through the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for Physician Quality Reporting programs, the Merit-Based Incentive Program, and the CAHPS for Accountable Care Organizations (ACOs) Survey administered by ACOs participating in the Medicare Shared Savings Program. The SSM is the percentage of patients who gave positive responses on experience in sharing decision making with providers on topics related to medications, procedures, and information sharing. A higher score indicates a better experience with shared decision making.

CMS set the CY 2017 target for this goal at 76 percent, which is between the 80th and 90th percentiles for all Shared Savings Program ACOs that used the CY 2015 Shared Savings Program quality measure benchmarks. The mean performance on this measure was 75.40 percent in CY 2016 and was 75.85 percent in CY 2017.

Because the agency implemented a revised shortened version of the survey in CY 2018 for both ACOs and MIPS, the CY 2018 performance period was a developmental year. CMS plans to re-establish the baseline for this goal based on the results from the new survey for CY 2018, which is expected to be available to CMS in April 2019. In addition, CMS intends to provide targets for CY 2019, CY 2020, and CY 2021 when the new survey scores are available.

Increase tele-behavioral health encounters nationally among American Indians and Alaska Natives (Lead Agency - IHS; Measure ID - MH-1)



FY 2013
			FY 2014
			FY 2015
			FY 2016
			FY 2017
			FY 2018
			FY 2019
			FY 2020Target
			N/A
			N/A
			8,600
			8,901
			10,359
			11,600
			13,600
			14,900Result
			7,397
			8,298
			9,773
			10,388
			12,212
			13,204
			12/31/20
			12/31/21Status
			Historic
			Actual
			Historic
			Actual
			Target
			Exceeded
			Target
			Exceeded
			Target
			Exceeded
			Target
			Exceeded
			Pending
			PendingIHS increased efforts to expand access to care through the integration of telemedicine with community-based services. An important specialty care delivered through this telehealth option includes behavioral health services. The FY 2018 target was 11,600, and the FY 2018 result was a total of 13,204 encounters. IHS exceeded its FY 2018 target by 14 percent. From FY 2013 to FY 2018, results for this measure increased by 79 percent. In FY 2019 and 2020, IHS will continue to expand access to care through telehealth behavioral services.

15A new cohort of FORHP Outreach grants is awarded for a three-year project period. During the first year of the project period, the number of people receiving direct services through the FORHP Outreach grants tends to be lower due to program start up. The numbers generally increase throughout the project period as outreach efforts are implemented.

16The methodology for this measure changed in CY 2018. Due to this change, a new baseline needs to be established before future targets are set.

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Content created by Office of Budget (OB) Content last reviewed March 29, 2019 Back to top
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