title: The Method for Performance Measurement Matters: Diabetes Care Quality as Measured by Administrative Claims and Institutional Registry.
abstract: OBJECTIVE
  Performance measurement is used by health care providers, payers, and patients. Historically accomplished using administrative data, registries are used increasingly to track and improve care. We assess how measured diabetes care quality differs when calculated using claims versus registry.
  
  
  METHODS
  Cross-sectional analysis of administrative claims and electronic health records (EHRs) of patients in a multispecialty integrated health system in 2012 (n = 368,883).
  
  
  METHODS
  We calculated percent of patients attaining glycohemoglobin <8.0 percent, LDL cholesterol <100 mg/dL, blood pressure <140/90 mmHg, and nonsmoking (D4) in cohorts, identified by Medicare Accountable Care Organization/Minnesota Community Measures (ACO-MNCM; claims-based), Healthcare Effectiveness Data and Information Set (HEDIS; claims-based), and registry (EHR-based).
  
  
  METHODS
  Claims were linked to EHR to create a dataset of performance-eligible patients.
  
  
  RESULTS
  ACO-MNCM, HEDIS, and registry identified 6,475, 6,989, and 6,425 measurement-eligible patients. Half were common among the methods; discrepancies were due to attribution, age restriction, and encounter requirements. D4 attainment was lower in ACO-MNCM (36.09 percent) and HEDIS (37.51 percent) compared to registry (43.74 percent) cohorts.
  
  
  CONCLUSIONS
  Registry- and claims-based performance measurement methods identify different patients, resulting in different rates of quality metric attainment with implications for innovative population health management.
authors: Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.|Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors: Rozalina G
authors: RG
authors: McCoy
authors: Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Sidna M
authors: SM
authors: Tulledge-Scheitel
authors: Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors: James M
authors: JM
authors: Naessens
authors: Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors: Amy E
authors: AE
authors: Glasgow
authors: Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Robert J
authors: RJ
authors: Stroebel
authors: Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Sarah J
authors: SJ
authors: Crane
authors: Department of Family Medicine, Mayo Clinic Health System, Owatonna, MN.
authors: Kari S
authors: KS
authors: Bunkers
authors: Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors: Nilay D
authors: ND
authors: Shah
mesh_terms: D060866:Accountable Care Organizations / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D008297:Male; D006278:Medicare; D008875:Middle Aged; D008910:Minnesota; D011787:Quality of Health Care; D012042:Registries / Q000706:statistics & numerical data*; D014481:United States
keywords: Performance measures; population health; quality improvement; registry