HEALTH CARE REPORT CARDS UNLOCKING THE SECRET OF QUALITY CARE ILRU WEBCAST July 1, 2004 Peg Mastal, PhD, RN

What is a Health Care Report Card? A health care report card is a published document that measures and compares the quality of care delivered by health care providers: –Individual or group of physicians –Managed care organizations (MCOs) –Hospitals –Nursing homes –Home health agencies (Maryland Department of Health and Mental Hygiene, 2004)

What is quality health care? Quality health care means doing:  The right thing  At the right time  In the right way  For the right person  Having the best possible results Today we talk about quality health care in terms of its value – value is an blend of: –Quality –Cost

History of Health Care Report Cards Health care report cards are a fairly recent development, a result of different major influences over the past 15 years: –The federal government (circa ) –Societal influences (1980s-present) –Advance of information technology (1990s) –Health care trends (late 1980s-present)

Federal Government Role  Health Care Finance Administration (HCFA) first published hospital mortality rates on a national level (late 1980s)  HCFA continued publishing annual mortality rates and added other measures  Center for Medicare and Medicaid Services (CMS) (2002) –Required public reporting (CMS website) on 9 measures of nursing home quality –Hospitals and home health agency reporting required in the near future  Government Agencies

Societal Influences  Advancing sophistication about consumer purchasing power (over the 1990’s)  Journals, magazines and other media reported quality of diverse products and services –Consumer Reports –Checkbooks –U.S News and World Report –Time –Newsweek –Newspapers –Television and radio

Advances in Information Technology  Advancing expertise in computer software including database development and use  Increasing use of statistical analysis  Development of the World Wide Web –Easy access to the web –Search engines instantly collate vast quantities of data, easing access to information –Consumers’ developing expertise and increasing comfort in using the web

Major Health Care Industry Trends  Growth of managed care and increasing focus on primary and ambulatory care services  Regulatory agency (government and private) oversight of different health care providers required standard reporting measures (1990s)  Accreditation of managed care organizations – the gold standard being the National Committee on Quality Assurance (NCQA) in the 1990s –Health Care Employer Data Information Set (HEDIS) –Consumer Assessment of Health Survey (CAHPS)

Report Card for Persons with Disabilities  A report card for persons with disabilities does not exist  Persons with disabilities have unique needs that should be measured uniquely  Measures of the quality of their care should be identified by persons with disabilities, their caregivers, care providers and by advocates for improved health states for persons with disabilities –Build on report card measures already in use –Identify measures specific to meeting the unique health care needs of persons with disabilities