CASE 1-13 Data Collection for the Healthcare Effectiveness Data and Information

CASE 1-13

Data Collection for the Healthcare Effectiveness Data and Information Set (HEDIS) in Managed Care

(Answer In APA format)

The managed care delivery system you have been employed with over the past few months is struggling in some areas of patient care and information systems for capturing and reporting patient care. You sit on a committee to develop an organizational quality improvement program for the organization. In preparation for the next administrative staff meeting, you are to report on healthcare effectiveness data and information set (HEDIS) elements reported and benchmarked among managed care providers.

As the HIM manager, you initially plan to visit www.ncqa.org and review professional literature to research HEDIS data element requirements.

• 1. Develop a list of the care measures tracked among different patient populations. Review National Committee for Quality Assurance (NCQA) report on “The State of Health Care Quality 2011: Continuous Improvement and the Expansion of Quality Measurement.”

• 2. Develop a summary of the patient populations reviewed and report findings relative to different conditions. Briefly summarize the chronic diseases measured, children and adolescent conditions, and older adult conditions from, the 2011 Quality Measurement Report.