Quality

The Catalyst for Payment Reform has provided a number of resources on different quality topics. Employers can create an account to access the toolkits and resources at no charge.

The Center for Value Based Insurance Design (V-BID) is built on the principle of lowering or removing financial barriers to essential, high-value clinical services. V-BID, based out of the University of Michigan, has put together a number of resources focusing on health care quality and costs. Please check out the following resources for more information on low value care and consumer cost sharing.

The National Alliance of Healthcare Purchaser Coalitions provides many resources on quality and cost, including this resource that explains the Choosing Wisely® initiative. Employers can use this resource to better understand the initiave and find tools to address unnecessary care and ways to improve quality, safety and efficiency. This second resource focuses on lowering costs by looking at biosimilar prescription drugs.

The National Committee for Quality Assurance (NCQA) put together a toolkit for employers to assess mandate and incentivize health plan quality. To access the free toolkit, provide your name, organization and email address.

Quality Compass
Responsible Agency: NCQA - Compilation
of managed care organization (MCO) data including NCQA’a accreditation
results and HEDIS (Healthplan Employer Data Information Set) http://www.ncqa.org/tabid/177/Default.aspx

Agency for Healthcare Research and Quality (AHRQ)
Committed to helping the Nation improve our health care system. To fulfill its mission, AHRQ conducts and supports a wide range of health services research. http://www.ahrq.gov/

Maryland Health Care Commission
An independent regulatory agency whose mission is to plan for health system needs, promote informed decision-making, increase accountability, and improve access in a rapidly changing health care environment by providing timely and accurate information on availability, cost, and quality of services to policy makers, purchasers, providers and the public. http://mhcc.maryland.gov/

Behavioral Risk Factor Surveillance System (BRFSS)
Responsible Agency: CDC/National Center for Chronic Disease Prevention and Health Promotion
BRFSS is an annual survey that asks respondents about a variety of diseases, including diabetes, as well as health behaviors. http://www.cdc.gov/brfss/

Health Care Utilization Project (HCUP) HCUPnet
Responsible Agency: AHRQ Center for Organization and Delivery Studies (CODS) Hospital discharge data from UB92s (all payers) submitted by states; now (2002) getting data from 29 states which represent 80% of all US hospital adms. http:/hcupnet.ahrq.gov/

NHANES III
Responsible Agency: CDC National survey with 3 data sets: 1) Self Reported 2) Medical Exam 3) Lab
http://www.cdc.gov/nchs/nhanes.htm

Centers for Medicare and Medicaid Services and State Quality Improvement Organizations (QIOs)
Responsible Agency: Delmarva Foundation (MD & DC) Virginia Health Quality Center (VA) Medicare claims data (inpatient, ED, outpatient hospital, physician office, home health agency, SNF); HbA1c testing is annual rate; eye exam and lipid profile are a biennial rate DC) http://www.dcqio.org/ 
Maryland) http://www.mdqio.org/  Virginia) http://www.vhqc.org/

Provider Recognition Program
Responsible Agency: National Committee for Quality Assurance -NCQA- Data obtained from medical record and patient survey)The Provider Recognition Program (PRP) recognizes physicians who meet the standards of diabetes care established by the program. The PRP performance indicators and outcomes measures represent consensus standards for appropriate treatment for diabetes patients. http://www.ncqa.org/tabid/74/Default.aspx

National Hospital Discharge Survey (NHDS)
Responsible Agency: CDC/ National Center for Health Statistics
NHDS is an annual review of a sample of hospital discharge records which includes demographic, diagnosis, and procedure data for each selected hospital admission. http://www.cdc.gov/nchs/about/major/hdasd/nhds.htm