Effects of Health Plan Report Cards on Quality of Care

描述（由申请人提供）：大量资源已经并将继续用于编制和公开传播比较健康计划绩效的报告。医疗补助和医疗保险服务中心（CMS）通过要求参与“医疗保险+选择”项目的医疗计划提供标准化的绩效衡量标准，在推动这些努力方面一直处于领先地位。尽管健康计划绩效衡量和报告的目标是通过向消费者提供必要的信息，以便将质量纳入其医疗保健购买决策，并向提供者提供有关其绩效与其他人比较的信息，从而提高医疗保健质量，但缺乏支持这些干预措施有效性的证据。本研究的目的是检验健康计划参与医疗保险受益人使用测量服务的质量测量和报告的影响。我们的研究将有两个具体目的：(1)确定强制性健康计划参与标准化质量测量和绩效的实施如何影响参加这些计划的医疗保险受益人对测量服务的利用；(2)确定强制性绩效衡量和报告是否影响了传统医疗保险受益人对衡量服务的利用。为了实现第一个目标，我们将检查在强制参与HEDIS绩效评估和报告之前和之后，参加医疗保险+选择计划的老年医疗保险受益人对计量服务的利用情况，并比较这些受益人与参加传统医疗保险的受益人之间的变化。我们将通过检验在实施强制性质量报告之前和之后，Medicare+Choice的市场水平注册对传统Medicare注册个人测量服务利用率的影响来实现第二个目标。我们分析的主要数据来源将是现行医疗保险受益人调查。如果我们实现了这些目标，我们将提供对评估消费者报告卡在提高护理质量方面的有效性至关重要的信息。这些信息对于医疗保险计划和雇主等大购买者以及政策制定者决定这些类型的干预措施在提高医疗质量方面的适当作用至关重要。

DESCRIPTION (provided by applicant): Significant resources have been and continue to be devoted to the development and public dissemination of reports comparing the performance of health plans. By requiring health plans participating in the Medicare+Choice program to provide standardized measures of performance, the Centers for Medicaid and Medicare Services (CMS) has been a leader in promoting these efforts. Although the objective of health plan performance measurement and reporting is to improve the quality of healthcare by providing consumers with the information necessary to incorporate quality into their health care purchasing decisions and providers with information on how their performance compares with others, evidence supporting the effectiveness of these interventions is lacking. The objective of this research is examine the effect of health plan participation in quality measurement and reporting on the use of measured services by Medicare beneficiaries. Our research will have two specific aims: (1) To determine how the implementation of mandatory health plan participation in standardized quality measurement and performance affected the utilization of measured services among Medicare beneficiaries enrolled in these plans; and (2) To determine whether mandated performance measurement and reporting affected the utilization of measured services by beneficiaries enrolled in traditional Medicare. We will achieve the first objective by examining the utilization of measured services among elderly Medicare beneficiaries enrolled in Medicare+Choice plans before and after the implementation of mandated participation in HEDIS performance measurement and reporting and comparing changes among these beneficiaries to those enrolled in traditional Medicare. We will achieve the second objective by examining the effect of market level enrollment in Medicare+Choice on utilization of measured services among individuals enrolled in traditional Medicare before and after the implementation of mandatory quality reporting. The primary data source for our analyses will be the Medicare Current Beneficiary Survey. If we achieve these objectives, we will have provided information which is crucial for evaluating the effectiveness of consumer report cards in improving quality of care. This information is essential for both large purchasers, such as the Medicare program and employers, and policy makers to determine the appropriate role of these types of interventions in improving quality of care.