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OUTLINE

OUTLINE. What States Are Doing Now What Is Available Now Mechanisms to Influence Quality Choosing a Strategy What Should Be Available in ‘99 & ‘00 Next Steps. WHAT STATES ARE DOING NOW. Use of Quality Measures in Medicaid Collection of measures Use of measures

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OUTLINE

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  1. OUTLINE • What States Are Doing Now • What Is Available Now • Mechanisms to Influence Quality • Choosing a Strategy • What Should Be Available in ‘99 & ‘00 • Next Steps

  2. WHAT STATES ARE DOING NOW • Use of Quality Measures in Medicaid • Collection of measures • Use of measures • Proposed Approaches in SCHIP Plans • Quality in separate programs • Performance measures

  3. STATE USE OF PERFORMANCE DATA, 1996-97 Landon BE. Et al. Jan. 1998. JAMA 279 (3)

  4. WHAT IS AVAILABLE NOW • HEDIS • Childhood immunizations • Adolescent immunizations • Well child visits in 15 months • Well child visits in 3rd to 6th year • Adolescent well care • CAHPS for 0 - 12 years

  5. MECHANISMS TO INFLUENCE QUALITY • Value-Based Purchasing • Consumer Information & Choice • Quality Improvement • Public Health Monitoring • Regulation

  6. CHOOSING A STRATEGY:USE OF MEASURES • Level of Accountability • Short Versus Long Term • Standardization Vs. Innovation • QMAS

  7. Level of Accountability

  8. CHOOSING A STRATEGY:STATE CHARACTERISTICS • Target Population • State Goals • Types of Plans Available • Market Share • Data Available

  9. CHOOSING A STRATEGY:DATA AVAILABLE • Health Plan Data • State Specific • Models From Other States • National Data

  10. CHOOSING A STRATEGY: CRITERIA FOR MEASURES & MEASURE SETS • Relevance • Scientific Soundness • Feasibility • Comprehensiveness • Balance

  11. CRITERION: RELEVANCE • Important • Meaningful • Potential for Improvement • Variation • Controllability

  12. CRITERION: SCIENTIFIC SOUNDNESS • Clinical Evidence • Process-Outcome Link • Reproducible • Valid • Accurate

  13. CRITERION: FEASIBILITY • Precisely Specified • Reasonable Cost • Logistically Feasible • Auditable • Confidentiality

  14. WHAT SHOULD BE AVAILABLE IN 1999 AND 2000 • Adolescent Survey Instrument • CAHPS Chronic Illness Instrument • RAND Global Quality Assessment Tool • Adolescent Mental Health • Avoidable Hospitalizations • Functional Status Measures

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