Effects of Health Plan Report Cards on Quality of Care

描述（由申请人提供）：大量的资源已经并将继续致力于发展和公共传播的报告比较健康计划的性能。通过要求参与医疗保险+选择计划的健康计划提供标准化的绩效衡量标准，医疗补助和医疗保险服务中心（CMS）一直是推动这些努力的领导者。虽然健康计划绩效测量和报告的目的是通过向消费者提供必要的信息，将质量纳入其医疗保健购买决策和提供者的信息，他们的表现如何与他人相比，以提高医疗保健的质量，证据支持这些干预措施的有效性是缺乏的。本研究的目的是探讨医疗保险受益人参与质量测量和报告对使用测量服务的影响。我们的研究将有两个具体目标：（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）确定强制性绩效测量和报告是否影响参加传统医疗保险的受益人对测量服务的利用。我们将实现第一个目标，通过检查测量服务的利用老年人医疗保险受益人参加医疗保险+选择计划之前和之后的强制参与HEDIS绩效测量和报告，并比较这些受益人之间的变化，那些参加传统的医疗保险。我们将通过研究Medicare+Choice的市场水平注册对传统Medicare注册的个人在实施强制性质量报告之前和之后使用测量服务的影响来实现第二个目标。我们分析的主要数据来源将是医疗保险当前受益人调查。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。这些信息对于大型购买者（如医疗保险计划和雇主）以及政策制定者来说都是必不可少的，以确定这些类型的干预措施在提高护理质量方面的适当作用。

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.