Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to describe how results-based accountability aids program evaluation.


Background:
Results-based accountability (RBA) is an excellent tool for program evaluation. Once the performance target (goal) is defined, milestones are developed to measure the progress toward the target. Riverside County VaxTrack implemented RBA in July 2004 to improve private provider participation, while striving to achieve the Healthy People 2010 goal for children in population-based immunization registries.


Setting:
Riverside County, CA


Population:
Over 115 private immunization providers were included in this study.


Project Description:
The Milestone Program encourages provider participation by rewarding providers based on their level of registry activity. As each milestone is reached, the incentive value increases. Prices ranged from approximately $2 to $10, and include promotional items such as mouse pads, insulated tumblers and “brief bags.” Because Medicaid Managed Care (MCMC) plans submit data electronically to VaxTrack, the performance target and milestones focused on increasing to 90% the number of non-MCMC children >6 years with immunization records in VaxTrack for 20 private providers. Milestones were set at 25%, 50% and 75% of non-MCMC children >6 years with immunization records in VaxTrack for 72, 60 and 40 providers, respectively.


Results/Lessons Learned:
Data extracted from VaxTrack and the Provider Management Database assessed each provider's progress toward the performance target. Although providers appeared to be achieving milestones, initial data analysis indicated that some milestones were “achieved” without providers actively using VaxTrack. Queries did not differentiate between immunizations entered by the provider from those entered by VaxTrack staff as part of historical data entry. As a result, the performance targets and milestones were revised to measure consistent data entry by provider offices, which guarantees that providers are rewarded for active registry use. Early results show that 32% - 42% of private providers actively use VaxTrack, up from 26% in July 2004.