been evolving,2 it is being used by all the major government programs, has been incorporated in the Health Plan Employer Data and Information Set (HEDIS) (see below), and is required in CMS managed care contracts (although not in Medicare FFS). DQIP includes abstracting and quality improvement tools as well as a technical assistance hotline.

End Stage Renal Disease Clinical Performance Measures

This set of process and outcome measures is used by CMS to monitor and improve the care provided by dialysis facilities. The measures include indicators of the adequacy of hemodialysis and peritoneal dialysis, vascular access, and anemia management. The public can obtain from the Medicare Website patient survival outcomes as well as other information for any dialysis facility receiving Medicare reimbursement. The ESRD CPMs have been credited for significant improvements in the quality of renal dialysis facilities (Jencks, 2001).

Health Plan Employer Data and Information Set

HEDIS was introduced by NCQA in 1991, and is updated annually to help purchasers and consumers compare the quality of commercial, Medicaid, and Medicare managed care plans. Its measures are used in many government health care programs, particularly in managed care settings. HEDIS incorporates other established standard measure sets, such as CAHPS, DQIP, and the Health Outcomes Survey (HOS). It encompasses the care of common health conditions, including asthma, cancer, depression, diabetes, and heart disease; patients’ perceptions of care received; and structural health plan attributes.

Minimum Data Set

The MDS is an 8-page set of core assessment items introduced by CMS in 1990 in all Medicare- and Medicaid-certified nursing homes principally for clinical assessment of nursing home residents. CMS is currently conducting a pilot project that involves regular disclosure of nine risk-adjusted quality measures, derived from the MDS, with the aim of promot-


DQIP has been a primary focus of NQF. In May 2002, the NQF Diabetes Measures Review Committee issued for public comment a draft set of diabetes measures drawn from the DQIP measures. The draft set was developed by the National Diabetes Quality Improvement Alliance, a collaboration of the American Medical Association, JCAHO, and NCQA.

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