Relationships Among Performance Measures for Medicare Managed Care Plans
Health Care Financing Review
|November 6, 2014
Summary
Integrating health plan performance measures like HEDIS, CAHPS, and HOS reveals key relationships. Analyzing these together improves understanding of health plan quality and beneficiary outcomes.
Area of Science:
- Health Services Research
- Healthcare Quality Measurement
- Health Outcomes Research
Background:
- The Health Care Financing Administration (HCFA) uses Health Employer Data Information Set (HEDIS®), Consumer Assessment of Health Plans Study (CAHPS®), and Medicare Health Outcomes Survey (HOS) for health plan performance tracking.
- Existing research has not fully elucidated the interrelationships between these commonly used health plan performance measures.
Purpose of the Study:
- To investigate the relationships between HEDIS measures, CAHPS items, and HOS items related to beneficiary general health.
- To determine if integrating these diverse measures enhances the interpretation of health plan performance data.
Main Methods:
- Statistical analysis was employed to examine the associations between specific HEDIS measures and various items within the CAHPS and HOS surveys.
- The study focused on identifying significant correlations and patterns among the selected performance indicators.
Main Results:
- Significant relationships were identified between four HEDIS measures and numerous items from the CAHPS measure.
- Key associations were also found between HEDIS measures and HOS items concerning beneficiary self-reported general health status.
Conclusions:
- The findings suggest that a comprehensive interpretation of health plan performance necessitates an integrated analytic framework.
- Combining measures of access, care effectiveness, patient experience, health status, and risk provides a more holistic view of plan quality.
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