1 / 22

ADVANCING HEALTH CARE QUALITY IN 2007 AND BEYOND

ADVANCING HEALTH CARE QUALITY IN 2007 AND BEYOND. Margaret E. O’Kane President, NCQA. NCQA: A Brief Introduction. Private, independent non-profit health care quality oversight organization Measures and reports on health care quality Committed to measurement, transparency and accountability

eyal
Download Presentation

ADVANCING HEALTH CARE QUALITY IN 2007 AND BEYOND

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. ADVANCING HEALTH CARE QUALITY IN 2007 AND BEYOND Margaret E. O’Kane President, NCQA

  2. NCQA: A Brief Introduction • Private, independent non-profit health care quality oversight organization • Measures and reports on health care quality • Committed to measurement, transparency and accountability • Unites diverse groups around common goal: improving health care quality

  3. NCQA: A Brief Introduction • Quality Measurement • HEDIS, CAHPS • Accreditation, Certification, Recognition • Health Plans, Physicians and Physician Groups,Health Care Organizations (such as DM providers) • Public Reporting • State of Health Care Quality, America’s Best Health Plans, Healthchoices.org, third-party partnerships • Research • Quality measures development • Cultural disparities in health care

  4. A MEASUREMENT SUCCESS STORY: BETA-BLOCKER TREATMENT AFTER A HEART ATTACK

  5. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 National average: 62.6%

  6. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 74.1%

  7. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 79.7%

  8. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 National average: 85.0%

  9. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 National average: 89.4%

  10. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 National average: 92.5%

  11. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 : 93.5%

  12. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 : 94.3%

  13. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 : 96.2%

  14. BETA-BLOCKER TREATMENT AFTER A HEART ATTACK 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 : 96.6%

  15. ADVANCING QUALITYIN 2007 AND BEYOND

  16. THE IMPACT OF IMPROVEMENT: What is the System Supposed to Do? A: Move people from right to left—and keep them there Health care spending Healthy/ Low Risk At-Risk High Risk Active Disease Early Symptoms 20% of people generate 80% of costs A value-based health care system Source: HealthPartners

  17. PROMOTE WELLNESS • The primary function of the health care system is to cure illness • keep people healthy • We must re-emphasize primary care • The “medical home” needs to be further defined and promoted • The patient needs to be activated

  18. NURTURE THE EVIDENCE BASE • Gaps in evidence abound • Even where evidence has been developed, there are too few tools to translate knowledge into practice • Appropriateness of care needs further study – it’s tightly linked to quality IMPROVEDPRACTICE NEWEVIDENCE

  19. HOW MUCH HEALTH DO WE GET FOR THE HEALTH CARE DOLLAR? • Relative Resource Use measures calculate risk-adjusted observed cost/expected cost for critical conditions: • Cardiac conditions, diabetes, asthma, COPD, low back pain, hypertension • These conditions account for 60% of all spending • Along with related quality results, allows for plan-to-plan comparisons on value

  20. A COMPREHENSIVE DELIVERY FRAMEWORK • Whose job is it to do what? • How do we design units of measurement to encourage effective, efficient care?

  21. PAYMENT, ACCOUNTABILITY REFORM • Pay for better care, not more care • The system, as it is, rewards bad care • Cost increases are being shifted to workers—or worse, leaving some out of the system altogether

  22. THE TRINITY OF CARE: GOOD CARE DOESN’T EXIST WITHOUT ALL THREE QUALITY ACCESS AFFORDABILITY

More Related