Toward the Development of Uniform Reporting Standards for Managed Care Organizations: The Health Plan Employer Data and Information Set (Version 2.0)

Corrigan, Janet M.; Nielsen, Don

doi:10.1016/s1070-3241(16)30037-2

Cited by 68 publications

(24 citation statements)

References 4 publications

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“…This is especially important as prac¬ tice immunization rates have been cited as one of the few objective measures of quality in preventive health care. 26 As more sophisticated electronic medical record and billing systems are created and adopted by practition¬ ers, these systems could provide new methods for mea¬ suring and tracking immunization rates in practice. Some have suggested the development of a personal elec¬ tronic immunization record that could be carried by par¬ ents and updated each time an immunization is given.27 As well, there is ongoing development of regional im¬ munization registries.28 Rodewald et al29 have described the use of billing records to create such a registry.…”

Section: Methodsmentioning

confidence: 99%

Methodological Issues in Determining Rates of Childhood Immunization in Office Practice

Darden

Taylor²,

Slora³

et al. 1996

Arch Pediatr Adolesc Med

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Section: Methodsmentioning

confidence: 99%

Methodological Issues in Determining Rates of Childhood Immunization in Office Practice

Darden

Taylor²,

Slora³

et al. 1996

Arch Pediatr Adolesc Med

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“…Another variation in healthcare is the report card -a comparative reporting system that allows healthcare purchasers and consumers to rank institutions. (Corrigan & Nielson, 1993). The Balanced Scorecard has also been suggested as a framework for evaluating the performance of an integrated health delivery system (Leggat & Leati, 1997).…”

Section: 41mentioning

confidence: 99%

Improving the Use of Information Systems for Hospital Management Using Balanced Scorecard Framework

Boafo¹,

Missah²,

Nyarko‐Boateng³

2017

IJSEA

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Hospital management teams receive voluminous data from variety of sources; these teams are unable to extract these data into the essential information for strategic decisions. It is as a result of this that this study is using a framework called the Balanced Scorecard (BSC), the development of an iterative prototyping system, user survey and focus group methods based on BSC to improve the use of information systems for Hospital management at Suntreso Government hospital. The study described in this paper has analyzed performance management tools like the Baldrige, the lean and balanced scorecard. The main focus is on the balanced scorecard management tool as a result of the numerous advantages it has over the others. The study used Balanced Scorecard (BSC) as part of a management control system for implementing strategies in Suntreso Government Hospital. A case study was conducted using the maternity and children's ward unit to measure innovations. Data was collected from DHMIS at the hospital before and after the end of the study, the information prototyping software developed, displays graphical relationships between key indicators like the length of stay, the average waiting time which shows progress in the PSUs. The results of the study is that SGH has adopted the concept, PSUs now formulate their plans using BSC, focus groups are satisfied with ease of access and the format of the information prototyping system. The study identified problems for the two patients units, then solutions were proposed to the management unit. That is using the balanced scorecard framework, a proposed information prototype system to check the average length of stay, the average waiting time, complication rate among others was provided.

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“…First, lack of standardization of quality indicators is being addressed by diverse initiatives [78][79][80][81][82][83]. Like clinical practice guidelines, quality indicators pertaining to processes and outcomes should be based on scientific evidence of relationships between those processes and outcomes.…”

Section: Improving Processes and Outcomes Of Carementioning

confidence: 99%

“…The Joint Commission on Accreditation of Health Care Organizations (JCAHO) is developing an indicator measurement system (IMSystem) that is projected eventually to be mandatory for organizations seeking JCAHO accreditation. And the National Committee for Quality Assurance (NCQA) has released a set of health plan performance measures, "The Health Plan Employer Data and Information Set Version 2.5" (HEDIS 2.5) [81,84] for trial use and evaluation by MCOs. Since many states have begun enrolling their Medicaid beneficiaries into MCOs, HEDIS is being modified to include quality indicators that address the special health needs of the Medicaid population [84].…”

Section: Improving Processes and Outcomes Of Carementioning

confidence: 99%

US health‐care revolution: cost and quality challenges

Larrabee

1996

International Journal of Quality Science

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SupplementThe US health-care system is experiencing a revolution, a major paradigm shift[1], as organizations "reinvent" themselves to put more emphasis on primary care and the holistic continuum of care than on illness care[2], as prepaid or capitated health plans rapidly gain market share in all geographical regions, and as health-care organizations [2][3][4][5], like other businesses [6], are deconstructing themselves through downsizing, re-engineering, and creating networks. Simultaneously, organizations that have embraced continuous quality improvement principles and strategies are experiencing incremental changes in their processes of care [7]. Clinicians may perceive these changes to be a veritable chaos, produced by data-free change strategies. Prediction of the future nature of the US health-care system is confounded by the lack of standardized clinical data elements and quality indicators, current telecommunications limitations, and the many complex, competing factors which are propelling change. Among these factors are concern for quality, the changing role of the consumer in health care, but, most especially, the concerted efforts to contain health-care cost escalation [2,8,9]. This article discusses challenges pertaining to these factors that providers, payers and policy makers must grapple with to shape the future US health-care system.First, consumerism and pursuit of market share challenge organizations to "reinvent" consumer-valued services and processes in a cost-effective manner that maintains or improves quality. Many such changes have been implemented without empirical data regarding the consequences of those changes. Research of the influence of various service delivery models on patient satisfaction and quality indicators is needed to help administrators and providers meet this challenge. Similarly, also needed is consumerism and the changing role of the consumer challenge providers to share information that meets their consumers' needs in a manner that they can use in making choices. This dimension of care continues to be a source of patient dissatisfaction. Research on the effectiveness of information sharing in various populations would help providers meet this challenge.Second, concerns for quality challenge organizations and providers to be accountable for improving processes and outcomes of care by decreasing practice pattern variation and associated differences in outcomes. Use of clinical practice guidelines has been initiated to help reduce practice pattern variation

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Toward the Development of Uniform Reporting Standards for Managed Care Organizations: The Health Plan Employer Data and Information Set (Version 2.0)

Cited by 68 publications

References 4 publications

Methodological Issues in Determining Rates of Childhood Immunization in Office Practice

Methodological Issues in Determining Rates of Childhood Immunization in Office Practice

Improving the Use of Information Systems for Hospital Management Using Balanced Scorecard Framework

US health‐care revolution: cost and quality challenges

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