|
|
|
|
What are the quality clusters for primary care and how are they used in the overall quality rating?
For primary care, quality information is grouped into the following clusters, which are weighted as shown below to create the overall quality score.
- Patient Experience
- Getting Care and Information - 10%
- Care and Communication - 10%
- Helping Patients Get Better Care
- Staying Healthy and Care for Illness - 20%
- Care for Chronic Conditions - 40%
- Health Information Technology and Generic Prescribing - 20%
The overall quality score is then converted into a star rating.
Providers must have results for at least half of the measures within a cluster in order for that cluster to be included in their overall quality assessment. Providers must have star ratings in all quality clusters to calculate an overall quality score.
What measures are used in the clusters?
The quality measures are listed below, according to cluster. Where applicable, the organization that endorsed the measures is also listed.
Patient Experience:
Getting Care and Information: the source for all of these measures is HealthPartners Consumer Choice satisfaction survey, conducted in 2009, with members as of May 2009.
Adult
Convenient appointments
Seeing the doctor of your choice
Getting an appointment for routine care
Getting an appointment for illness or injury
Waiting in the reception area
Waiting in the exam room
Information by phone during clinic hours
Information by phone after clinic hours
|
Child
Convenient appointments
Seeing the doctor of your choice
Getting an appointment for routine care
Getting an appointment for illness or injury
Waiting in the reception area
Waiting in the exam room
Information by phone during clinic hours
Information by phone after clinic hours
|
Care and Communication: the source for these measures is HealthPartners Consumer Choice satisfaction survey, conducted in 2009 with members as of May 2009.
Adult
How well doctor and staff listen
Time with the doctor
Explanations about tests or procedures
Willing to recommend
|
Child
How well doctor and staff listen
Time with the doctor
Explanations about tests or procedures
Willing to recommend
|
Helping Patients Get Better
Staying Healthy and Care for Illness:
Measure
Adult: Preventive care
|
Endorsing Organization
National Community for Quality Assurance (NCQA), National Quality Forum (NQF)
|
| Adult: Alcohol use
|
|
| Adult: Care for bronchitis
|
NCQA, NQF
|
| Adult: Healthy weight
|
NQF
|
| Adult: Care for back pain
|
NCQA, NQF
|
| Adult: Monitoring high blood pressure medications
|
NCQA, NQF
|
| Adult: Monitoring diuretic medications
|
NCQA, NQF
|
| Child: Preventive care
|
NCQA (components), NQF
|
| Child: Immunizations
|
NCQA, MNCM
|
| Child: Healthy weight
|
NQF
|
| Child: Care for a cold
|
NCQA, MNCM
|
| Child: Care for a sore throat
|
NCQA, MNCM
|
Care for Chronic Conditions:
| Measure |
Endorsing Organization |
| Asthma - adult |
NCQA, NQF |
| Asthma - child |
NCQA, NQF |
| Depression |
NCQA |
| Diabetes |
MNCM, NCQA, NQF |
| Heart disease |
MNCM, NQF |
| High blood pressure |
MNCM, NQF |
For this cluster, the source for eight measures in this cluster - immunizations, care for a cold, care for a sore throat, adult/child asthma, diabetes, heart disease and high blood pressure - is Minnesota Community Measurements 2009 Healthcare Quality Report, based on 2008 dates of service. See http://www.mnhealthcare.org.
The source of care for back pain is HealthPartners 2009 acute low back pain composite measure. The source of high blood pressure medications and diuretic medications is HealthPartners annual monitoring for patients on persistent medications, 2009.
For all other measures the source is HealthPartners 2009 Clinical Indicators Report, which provides 2008-2009 results. For further information, refer to 2009 Clinical Indicator Report .
Health Information Technology and Generic Prescribing
| Measure |
Endorsing Organization |
| Electronic medical record |
|
| Clinic Safety Assessment Survey |
|
| Prescribing generic medications |
|
| Explanations about prescription drugs |
|
| Explanations about drug side effects |
|
The sources for the measures in these clusters are as follows:
- Electronic medical record: Minnesota Community Measurement 20010 Health Information Technology Report and HealthPartners HEDIS/Clinical Indicator chart abstraction, 1Q 2009
- Prescription medications: HealthPartners 2009 Clinical Indicators Report
- Explanations about drugs and side effects: HealthPartners 2009 Consumer Choice survey
|
|
|
|
|
|
