Examples of How States Use Quality Measures
Child Health Care Quality Toolbox
Contents
- Arizona
- Michigan
- Minnesota
- New York
- North Carolina
- Ohio
- Rhode Island
- Vermont
- Washington State
- Wisconsin
Here are a few examples of how States use their performance measures and display them on their Web sites. We have included examples of Web-based reports that show Health Plan Employer Data and Information Set (HEDIS®) measures, Consumer Assessment of Health Plans (CAHPS®) survey results, and Child and Adolescent Health Measurement Initiative (CAHMI) measures. The names and current locations of their latest reports, as well as the home page of the agency sponsoring the report, are listed. If the location of the report on the agency's Web site is changed or should newer reports become available, you should be able to find them on the agency's home page.
Annual KidsCare Report to the Governor
The Arizona Health Care Cost Containment System provides an annual report to the Governor and members of the public on the performance of the KidsCare program, Arizona's State Children's Health Insurance Program (SCHIP). Three of the measures included in the report are based on HEDIS®: immunizations, well child care visits, and access to primary care practitioners.
Online Resources:
For the home page of the agency, go to: https://www.azahcccs.gov/.
2001 Medicaid Consumer Satisfaction Survey
The Medical Services Administration (MSA) of the Michigan Department of Community Health administers the State's Medicaid program. The MSA uses the CAHPS survey instrument to conduct annual consumer satisfaction surveys of beneficiaries enrolled in health plans under Medicaid.
Online Resources:
For the Michigan Department of Health & Human Services home page, go to: http://www.michigan.gov/mdhhs.
The consumer-oriented brochure, "Guide to Michigan Medicaid Plans," is another Michigan Department of Community Health quality initiative. To download the report in PDF format (179 KB), go to: http://www.michigan.gov/documents/QualityCheckup02_11547_7.pdf.
HEDIS® 2003 Medicaid Managed Care Results
The Minnesota Department of Human Services produced a report, HEDIS® 2003 Medicaid Managed Care Results, showing multiple HMO rates for six child HEDIS indicators for Medicaid and commercial populations. The previous year's report, Primer on the Medicaid and MinnesotaCare HEDIS 2002, showed similar data in a more detailed format with explanations of how to use HEDIS data.
Online Resources:
http://www.health.state.mn.us/divs/hpsc/mcs/hedis02.htm
For the department's home page, go to: https://mn.gov/dhs/.
Managed Care Plan Performance—Quality, Access to Care, and Consumer Satisfaction
The Bureau of Quality Management and Outcomes Research, Office of Managed Care, New York State Department of Health uses performance measures to assess and improve the quality of care and increase the accountability of all managed care plans licensed to operate in New York State. The measures, known as Quality Assurance Reporting Requirements, are largely adopted from HEDIS®.
The report includes information on plans serving commercial, Medicaid, and the State's SCHIP (Child Health Plus) enrollees. Plan results are compared to national averages and goals where possible.
Online Resources:
For more information and a link to the report, go to:
https://www.health.ny.gov/publications/3346_2012.pdf.
For the home page of the New York managed care office, go to: https://www.health.ny.gov/health_care/managed_care/.
Comparisons of HEDIS Results by Systems of Care
The North Carolina Division of Medical Assistance Managed Care Quality Management Section produced one of the few reports that includes children with special needs. This report showed the results of 16 HEDIS® benchmarks for four programs including primary care case management.
Online Resources:
For the Division of Medical Assistance home page, go to: https://dma.ncdhhs.gov/.
Medicaid Managed Care Customer Satisfaction Survey
Ohio's Health Plans, a division of the Ohio Department of Job and Family Services, administers Medicaid and SCHIP, among other programs. The Department uses the CAHPS survey instrument to gather data and develop a report assessing consumer satisfaction under Medicaid managed care and fee-for-service programs.
Online Resources:
For the most recent report, go to: http://medicaid.ohio.gov/RESOURCES/ReportsandResearch/MedicaidManagedCareReports.aspx#807303-customer-satisfaction-surveys.
For the agency's home site, go to: http://medicaid.ohio.gov/.
Analysis of RIteCare Utilization Data: Asthma Surveillance 1998-2002
Rhode Island 's RIteCare program includes Medicaid and SCHIP. It is administered by the Rhode Island Department of Human Services, which conducts special studies on issues of relevance to the enrolled population. A report monitoring trends in the diagnosis and treatment of asthma from 1998 to 2002 was prepared in 2003.
Online Resources:
For other Rlte reports, go to: http://www.eohhs.ri.gov/Consumer/FamilieswithChildren/RIteCare.aspx.
Health Care Quality Report
The Vermont Program for Quality in Health Care (VPQHC), a private, nonprofit corporation formed in 1998, produces an annual report that measures health care quality and utilization across Vermont based on a set of commonly used indicators, including HEDIS measures. In addition, the report highlights specific efforts VPQHC and others have undertaken to improve health care quality for Vermonters.
Online Resource: To access the most current Quality Report, go to: http://www.vpqhc.org/interior.php/pid/17/sid/204
2002 CAHPS® Results
In 1997, Washington State's Department of Social and Health Services Medical Assistance Administration began conducting CAHPS for Medicaid clients. Assessments were based on the health care services and experiences of:
- Healthy Options general child population.
- Healthy Options children with chronic care conditions population.
- Kaiser Foundation Health Plan child population.
- Children in SCHIP.
Results of the survey were published in a report titled 2002 Washington Consumer Assessment of Health Plans (CAHPS®) Survey: Washington State Medicaid Client Satisfaction Results.
2003 HEDIS® Report
The Quality Assessment, Improvement, and Monitoring office of the Division of Medical Management, Medical Assistance Administration of the Washington State Department of Social and Health Services produced a report showing Medicaid and commercial rates for seven HEDIS® benchmarks.
Promoting Healthy Development Survey
In 2000, Washington State served as a pilot site for two Child and Adolescent Health Measurement Initiative (CAHMI) products. A pilot of the Promoting Healthy Development Survey (PHDS) included Washington State Healthy Options children served by nine managed care organizations, as well as children receiving care through Washington fee-for-service and primary care case management programs.
Online Resources:
For the home page of Washington's Health Care Authority, go to: https://www.hca.wa.gov/.
For the CAHMI home page, go to: http://www.cahmi.org.
MEDDIC-MS and MEDDIC-MS
Automated clinical performance measures called MEDDIC-MS and MEDDIC-MS SSI have been in use in Wisconsin since 2002. These measures are specifically designed for very large healthcare delivery systems for Medicaid, SCHIP, and Supplemental Security Income (SSI) populations.
Wisconsin publicly reports 58 measure numerators for 14 health maintenance organizations (HMOs) in Family Medicaid and SCHIP programs and 34 measure numerators for the SSI program; Wisconsin is the only State publicly reporting SSI managed care quality data. Data on additional numerators for specific age cohorts are also collected. Public reporting has encouraged HMOs to focus on performance improvement and sustained improvement has occurred in a number of key indicators.
Online Resource:
For more information on MEDDIC-MS and MEDDIC-MS SSI performance measures and the latest clinical performance data for Wisconsin, go to:
http://www.dhs.wisconsin.gov/emsc/mission.htm.
