Quality Improvement

Quality in Healthcare

There are two things we can focus on when we talk about quality:

Quality Assurance

&

Quality Improvement

While they may seem the same, QA and QI are very different!

Quality Assurance

QA = Maintain

  • You reach a certain level that is exceptable

  • Than you try not to slip below it

Example: Benchmark

Quality Improvement

QI = Continuous

  • Make changes that increase quality

  • You always seek to improve upon past performance

Example: Exceed the Benchmark and move the average


Quality Assurance

  • Individual focused

  • Perfection myth

  • Solo practitioners

  • Peer review ignored

  • Errors punished

Quality Improvement

  • Systems focused

  • Fallibility recognized

  • Teamwork

  • Peer review valued

  • Errors seen as opportunities for learning

Quality Improvement seeks to:

  • Standardize processes

  • Structure to reduce variation

  • Achieve predictable results

  • Improve outcomes for patients, healthcare systems, and organizations

Quality in Healthcare

  • How do we deploy finite resources to maximize financial impact and document care quality?

  • How do we navigate the complexity of financial reporting, while avoiding the pursuit of unnecessary and wasteful gap closure activities?

What are we trying to accomplish?

How will we know that a change is an improvement?

What changes can we make that will result in improvement?

HEDIS DATA:

HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance.

Administrative Data

  • Consists of claim or encounter data submitted to the health plan

Hybrid Data

  • Requires reviews of a random sample of member medical records

  • To abstract data for services rendered but that were not reported to the health plan through claims/encounter data

How can I improve my HEDIS SCORE

1. Submit claim encounter for each and every service rendered

2. Make sure that chart documentation reflects all services billed

3. Bill (or report by encounter submission) for all delivered services, regardless of contract status

4. Ensure that all claim/encounter data is submitted in an accurate and timely manner

5. Consider including CPT II codes to provide additional details and reduce medical record requests

TWO Big Questions to Ask

  • How do we deploy finite resources to maximize financial impact and document care quality?

  • How do we navigate the complexity of financial reporting, while avoiding the pursuit of unnecessary and wasteful gap closure activities?

Today’s health plans need to employ a Data-Driven Triad:

Gap identification


Strategic intervention


Dynamic recalibration


Close Quality gaps with those aimed at Documentation and Coding

to

Produce a coordinated road map that is:


More efficient for the plan



Less disruptive to providers



More respectful of the members