Assessing quality of care via HEDIS 3.0. Is there a better way?
Patients, employers, and third-party payers are all calling for improved measures of health care quality. This has led to the development of "report cards," assessments that are many times applied not just to health plans but also to providers. One attempt at creating a standardized set of quality and effectiveness measures is the Health Plan Employer Data and Information Set (HEDIS). The HEDIS measures are based primarily on analyses of administrative data sets. Problems with HEDIS measures, including the probability that plans will use different data collection methods and a lack of risk adjustment, may result in incorrect conclusions about the quality of care delivered by various providers. An alternative method of standardized surveys is proposed that will overcome many of the limitations of the current HEDIS measures, provide outcome rather than process data, and provide data for developing interventions to improve quality.
Mainous
A G
AG
Department of Family Medicine, Medical University of South Carolina, Charleston, USA. mainouag@musc.edu
Talbert
J
J
D003627:Data Interpretation, Statistical; D006279:Health Maintenance Organizations / Q000592:standards*; D006801:Humans; D007114:Immunization / Q000592:standards; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care; D012984:Software; D014481:United States