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The Healthcare Effectiveness Data and Information Set ( HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance (NCQA). HEDIS was designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks.
Monitoring and evaluation. Monitoring and Evaluation ( M&E) is a combined term for the processes set up by organizations such as companies, government agencies, international organisations and NGOs, with the goal of improving their management of outputs, outcomes and impact. Monitoring includes the continuous assessment of programmes based on ...
In the healthcare industry, pay for performance ( P4P ), also known as " value-based purchasing ", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for ...
The Healthcare Quality Improvement Act of 1986 (HCQIA) was introduced by Congressman Ron Wyden from Oregon.(Title 42 of the United States Code, Sections 11101 - 11152) It followed a federal antitrust suit by a surgeon against an Astoria hospital and members of its clinic in which he claimed antitrust actions were effected through the mechanism of peer review in the hospital.
Performance measurement. Performance measurement is the process of collecting, analyzing and/or reporting information regarding the performance of an individual, group, organization, system or component. [dubious – discuss] [1] Definitions of performance measurement tend to be predicated upon an assumption about why the performance is being ...
t. e. Healthcare in the United States is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, and a significant proportion of its population lacks health insurance.
In 2015 CMS identified 254 quality measures for which providers may choose to submit data. The measures map to U.S. National Quality Standard (NQS) health care quality domains: Communication and Care Coordination; Community/Population Health; Effective Clinical Care; Efficiency and Cost Reduction; Patient Safety
The American Health Information Management Association ( AHIMA) is a professional association for health professionals involved in the health information management needed to deliver quality health care to the public. Traditionally focused mainly on hospitals and paper medical records, the field presently covers all health information ...