PODCAST: NCQA and HEDIS [Health Effectiveness Data Information Set]

90 NCQI MEASUREMENTS

BY ERIC BRICKER MD

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of U.S. health plans to measure performance on important dimensions of care and service. More than 190 million people are enrolled in health plans that report quality results using HEDIS.

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HEDIS Explained - BHM Healthcare Solutions

CITE: https://www.r2library.com/Resource/Title/0826102549

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The National Committee for Quality Assurance is an independent 501 nonprofit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation.

CITE: https://www.r2library.com/Resource/Title/0826102549

MORE: https://www.dhcs.ca.gov/provgovpart/Documents/6422/NCQAAccreditationOverview-1-21-20.pdf

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Higher Spending on Healthcare Doesn’t Always Deliver Quality

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Law of Diminishing Returns

[By Staff Reporters] 

Health plans that spend the most on care don’t always deliver the best quality, concludes a new report from the National Committee for Quality Assurance (NCQA).

The Costly Chronic Illnesses

Insurers said they spend most on five costly, common chronic illnesses–asthma, cardiovascular disease, chronic obstructive pulmonary disease, diabetes and hypertension.

However, there was a high degree of variation among plans and no clear correlation between resource use and quality.

Quality Medial Management

Assessment

Sources:

http://www.fiercehealthpayer.com/story/insurers-high-spending-care-doesnt-always-deliver-quality/2010-10-15?utm_medium=nl&utm_source=internal

http://theincidentaleconomist.com/wordpress/how-do-we-rate-the-quality-of-the-us-health-care-system-%e2%80%93-infrastructure/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+TheIncidentalEconomist+%28The+Incidental+Economist+%28Posts%29%29

Is this like the domestic public education system, or a modification of the Laffer Curve in economics?

Conclusion

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Medicare and Medicaid Health IT Network Proposal

Governmental Initiative for the Elderly and Poor

By Staff Reporters200298593-001

According to Nancy Ferris of Government Health IT, on Mar 18, 2009, a rapid learning health information data network could close some gaps in medical knowledge and cut costs for Medicare and Medicaid recipients.

A Congressional Letter

In a letter to Congress, a group of health policy experts urged creation of a network to share information on Medicare and Medicaid patients in order to improve treatment received. In particular, Lynn Etheredge, one signatory of the letter, wants information to be shared on “dual eligible’s”. This term is defined as low income, elderly patients who receive money for medical care from both Medicare [Federal] and Medicaid [State] sources.dhimc-book6

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According to Etheredge, there are 7 million such dually-eligible patients in the US, which represents 40 percent of Medicaid spending, and 25 percent of Medicare spending. Etheredge and the others suggest that a network backed by government policy would hasten treatments for everyone.

Assessment

Others who signed the letter include Kenneth Kizer, who created the health-records system for the Department of Veteran Affairs; Commonwealth Fund President Karen Davis; National Quality Forum [NQF] President and CEO Janet Corrigan and National Committee for Quality Assurance [NCQA] President Margaret O’Kane. 

Link: http://govhealthit.com/articles/2009/03/18/network-for-data-on-medicaid-medicare-patients.aspx

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. One conclusion of this letter was that“[Researchers] spend way too much time simply acquiring data.” Do you agree, why or why not? Please opine. Will networked eHRs, eMRs and eDRs really save money and time; or cost money and time? Can they be inter-operable and connected on a nationally networked basis that is cost-effective, secure and available to all providers? What about CCHIT, and other vendors?

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