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Reporting of Quality
Fact
Sheet: Reporting of Quality
Data
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Public
Reporting on Health
Care Provider Performance
by Medicare Quality
Improvement Organizations
National
Efforts
PRO-West,
a Seattle-based QIO,
has worked with Medicare
to develop Dialysis
Facility Compare, which
provides the public
with quality performance
information on dialysis
centers nationwide.
Dialysis Facility Compare
offers information
on individual treatment
centers including types
of dialysis available,
number of treatment
stations, and patient
survival rates. (see
www.medicare.gov.)
For
more information, call
Evan Stults at 206-364-9700.
IPRO,
a New York-based QIO,
has managed and published
HEDIS audits of all
Medicare-participating
HMOs in the nation.
HEDIS was developed
by the National Committee
for Quality Assurance
(NCQA) to facilitate
the development of
national standards
for quality health
care and to drive quality
improvement.
Using
a standardized set
of quality performance
measures, NCQA gives
employers, consumers
and regulators the
ability to measure
and compare the quality
of care delivered by
managed care organizations.
The HEDIS Compliance
Audit™, a standardized
audit methodology,
is used to verify the
integrity of collection
and calculation processes
and to ensure that
HMOs submit accurate
and complete HEDIS
data.
IPRO
staff assisted NCQA
in developing the HEDIS
Compliance Audit standards
and have collaborated
with NCQA to analyze
data collection and
calculation methods
used by health plans
and to assure that
HEDIS audit policies
evolve with the ever-changing
health care environment.
IPRO
has completed more
than 500 HEDIS Compliance
Audits since the inception
of the HEDIS program,
including the oversight
of two national audits
of Medicare HEDIS on
behalf of The Centers
for Medicare and Medicaid
Services (CMS).
For
more information, call
Spencer Vibbert at
516-326-7767.
Qualidigm,
a QIO based in Connecticut,
has joined with the
Centers for Medicare
and Medicaid Services;
The Joint Commission
on Accreditation of
Healthcare Organizations;
the Rhode Island Department
of Health (HEALTH);
and the Hospital Association
of Rhode Island to
work together on a
national approach to
support the responsible
public reporting of
information about the
quality of health care
services in various
settings.
The
initiative is currently
being tested in Rhode
Island in accordance
with a 1998 state law
that requires the public
reporting of care provided
by all health care
settings licensed by
HEALTH. Called the
Rhode Island Health
Care Quality Performance
Measurement and Reporting
Program, the first
public report will
focus on the quality
of health care services
provided in the hospital
setting.
In
early July 2001, HEALTH
released a report on
the hospital care given
to Medicare beneficiaries
for heart attack, heart
failure, atrial fibrillation,
stroke and pneumonia.
This report also measures
the quality of care
provided in the outpatient
setting in diabetes
treatment, adult immunization,
and breast-cancer detection.
Available on HEALTH’s
web site (www.healthri.org),
the report provides
a comparison of hospitals
in Rhode Island with
hospitals in the other
New England states
and the nation.
In
the fall of 2002, Rhode
Islanders will have
the opportunity to
learn the results of
patient-satisfaction
surveys done at all
the hospitals, in a
format comparing hospitals
with one another. In
2002, comparative information
on how well hospitals
meet standards for
certain medical procedures
will also be released
to the public.
For
more information, contact
Barry Waite at 860-632-6347
State-wide
Efforts
New
York’s IPRO is
a co-founder of a public/private
organization called
the New York State
Health Accountability
Foundation (NYSHAF),
which just published
its third annual commercial
Managed Care Report
Card, relying on data
from New York State
as well as NCQA performance
information and CAHPS
survey findings.
NYSHAF
also hosts a portal-style
website (http://abouthealthquality.org/)
featuring provider-specific
content from NCQA,
FACCT, and the New
York City-based Center
for Medical Consumers.
The site offers interactive,
customized HMO report
cards, disease management
tools, and information
on surgeon-specific
and hospital-specific
volume for elective
procedures in New York
State.
For
more information, call:
Spencer Vibbert at
516-326-7767.
MPRO,
a Michigan-based QIO,
conducts public reporting
of hospital quality
performance in partnership
with the major auto
companies, the United
Auto Workers, Michigan
Hospital Association;
State of Michigan,
and Blue Cross Blue
Shield of Michigan.
Known as the Southeast
Michigan Hospital Profiling
Program (SEMHPP), the
project provides consumers
with comparative provider
performance data on
the quality of care
delivered at 31 Southeastern
Michigan hospitals.
MPRO
has also been extensively
involved in the initiation
of a collaborative
benchmarking project
and the nationally
recognized Guidelines
Applied in Practice
(GAP) project, which
focuses on cardiac
care. On the GAP project,
MPRO is collaborating
with the American College
of Cardiology and the
same 31 hospitals in
Southeast Michigan.
As a member of the
Michigan Health and
Safety Coalition, MPRO
is facilitating refinement
of the Leapfrog Group's
initiatives in developing
common treatment guidelines
for six clinical areas
of care; voluntary
public reporting is
under consideration
as one of the implementation
strategies.
For
more information, call:
Charlene Brocklebank
at 734-459-0900.
Quality Partners of Rhode Island, a QIO based
in Providence,
recently teamed up
with ABT Associates
of Cambridge (MA) to
develop the Nursing
Home Performance Evaluation
Guide for the state
of Maryland that ranks
nursing homes according
to broadly accepted
quality measures.
The
Guide offers a detailed
look at over 200 comprehensive
care nursing facilities
and continuing care
retirement communities
in Maryland. Available
on the Internet at
www.mhcc.state.md.us,
the Guide provides
consumers with information
on quality of care
in four main categories:
clinical, functional,
psychosocial and medication-prescribing
care, as well as reports
on deficiencies observed
during recent state
inspections.
The
Guide ranks Maryland
nursing homes into
the top 20%, bottom
10%, and "all others"
in terms of quality
of care. Quality Partners of Rhode Island is
currently developing
a comparable public
reporting system on
quality of care in
Rhode Island to classify
nursing homes into
meaningful categories
for consumers.
For
more information, contact
David Gifford at 401-528-3261
Delmarva,
a Maryland-based QIO
is developing the
Maryland Hospital Performance
Report in partnership
with the Maryland Health
Care Commission (MHCC).
This project covers
the following three
areas: design and execution
of a consumer oriented
web based reporting
system for hospital
performance; analysis
of Health Service Cost
Review Commission data
to develop appropriate
outcome indicators
for inclusion in the
report; and development
of hospital-specific
process performance
measures.
For
more information, contact
Tom Schaefer at 410-822-0697.
Health
Services Advisory Group,
an Arizona QIO, has
partnered in California
with the Pacific Business
Group on Health and
the Office of Statewide
Health Planning and
Development in a groundbreaking
effort to evaluate
how well California
hospitals perform coronary
artery bypass graft
(CABG) surgery. The
study analyzed more
than 38,000 bypass
surgeries performed
at 79 hospitals over
a recent two-year period.
The first round of
results was publicly
released this year.
HSAG also has audited
HEDIS measures reported
by health plans and
conducted Consumer
Assessment of Health
Plan Surveys (CAHPS)
in seven states – Arizona,
Nevada, Colorado, Tennessee,
California, Michigan,
and Hawaii. This work
has resulted in the
publishing of a report
card on state health
plans in Colorado.
For
more information, contact
Patricia Dubick at
602-264-6382
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