Uses and Limitations of Claims-based Performance Feedback Reports: Lessons From the Comprehensive Primary Care Initiative
| Autor: | Perry Payne, Deborah Peikes, Arkadipta Ghosh, Ann S. OʼMalley, Lori Timmins, Randall Brown, Michael Barna, Kaylyn Swankoski, Margaret Gerteis, Timothy J. Day, Erin Fries Taylor |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Knowledge management Quality management media_common.quotation_subject Primary health care Insurance Claim Review Primary care Medicare Feedback 03 medical and health sciences 0302 clinical medicine Perception Medicine Humans In patient 030212 general & internal medicine media_common Performance feedback Primary Health Care business.industry 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Reproducibility of Results Middle Aged Quality Improvement United States Female 0305 other medical science business Delivery of Health Care User feedback |
| Zdroj: | Journal for healthcare quality : official publication of the National Association for Healthcare Quality. 40(4) |
| ISSN: | 1945-1474 |
| Popis: | BACKGROUND Performance feedback is central to data-driven models of quality improvement, but the use of claims-based data for feedback has received little attention. PURPOSE To examine the challenges, uses, and limitations of quarterly Medicare claims-based performance feedback reports generated for practices participating in the Comprehensive Primary Care (CPC) initiative from 2012 to 2015. METHODS Mixed methods study of nearly 500 CPC practices in seven regions, combining pilot testing; systematic monitoring; surveys; in-depth interviews; user feedback; and input from data feedback team. RESULTS Designing reports required addressing issues about timing, data completeness and reliability, variations in patient risk across practices, and use of benchmarks and metrics understandable to users. Practices' ability to use reports constructively depended on their experience, analytic resources, expectations, and perceptions about the role of primary care in improving reported outcomes. CONCLUSIONS Generating claims-based feedback reports that support practices' quality improvement efforts requires a significant investment of analytic expertise, time, resources, continuous improvement, and technical assistance. IMPLICATIONS Claims-based performance feedback can provide insight into patterns of patients' care across provider settings and opportunities for improvement, but practices need data from other sources to manage patients in real time or assess the short-term effects of specific changes in care delivery. |
| Databáze: | OpenAIRE |
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