Healthcare Effectiveness Data and Information Set (HEDIS®)
The Healthcare Effectiveness Data and Information Set (HEDIS®) is a widely used set of health care performance measures that is developed and maintained by the National Committee for Quality Assurance (NCQA). Examples of HEDIS® measures are Comprehensive Diabetes Care, Childhood Immunizations, yearly Well Child Exams for Children Ages 3-6 and yearly Adolescent Well Care Exams. For detailed information about HEDIS ®, please go to www.ncqa.org or read our 2013 HEDIS Tip Sheet. View the 2014 HEDIS tip sheet here.
Value Based Purchasing (VBP)
The Maryland Department of Health and Mental Hygiene (DHMH) Value Based Purchasing (VBP) program is designed to provide incentives and disincentives based on performance indicators which measure access and quality of care. The VBP measures change annually, and may differ from HEDIS ® measures. The Priority Partners HEDIS ® Tip Sheet is updated annually with information pertinent to VBP. View the 2013 tip sheet with VBP information here.The VBP Tip Sheet for 2014 can be found here.
Consumer Assessment Health Plan Surveys (CAHPS ®)
The Consumer Assessment of Healthcare Providers (CAHPS®) 5.0H is a member satisfaction survey whose objective is to capture information about consumer-reported experiences with healthcare. The focus of the survey is to measure how well plans are meeting member expectations, determine which areas of service have the greatest effect on overall member satisfaction, and identify areas of opportunity for improvement. Topics included in the survey are: Getting Needed Care, Getting Care Quickly, How Well Doctors Communicate, Customer Service, Claims Processing, Shared Decision Making, Plan Information on Costs, Coordination of Care, and the Ratings of Health Care, Personal Doctor, Specialist, and Health Plan. The survey is conducted according to NCQA protocol by an NCQA certified vendor.
There are many reasons health plan members, patients and caregivers may struggle to understand health information. Johns Hopkins HealthCare (JHHC) has structured its goals to meet their mission to provide quality health care and develop new methods to improve the health of its patient community and set standards of excellence in patient care. Areas of focus include doctor-patient communication, patient engagement, and health literacy as ways to develop shared decision making so patients better understand their healthcare needs. Initiatives such as health coaching and health literacy are examples of ways to encourage patients to ask questions to improve their understanding of their role in managing their behaviors and attitudes toward health maintenance. Providers should encourage their patients to ask questions and develop an open flow of communication. By having an engaged patient and developing a better means of communication through health literacy initiatives, healthcare providers can treat their patients who have a clear understanding of their healthcare plan and move toward achieving optimal health outcomes and favorable HEDIS® and CAHPS® results. For more information on health literacy tools for improved communication, visit the Agency for Healthcare Research and Quality website at http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/index.html