Medicare New Directions in Quality Assurance Proceedings (1991) / Chapter Skim
Currently Skimming:
23. An Administration Response to the Institute of Medicine Report from the Health Care Financing Administration
23. An Administration Response to the Institute of Medicine Report from the Health Care Financing Administration
Pages 179-185
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From page 179... ...
. PROBLEM AREAS IDENTIFIED BY THE HEALTH CARE FINANCING ADMINISTRATION IN THE PAST At the beginning of my involvement with the PRO program four years ago, we identified three major problem areas that were of sizable proportion.
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From page 180... ...
Consequently, we preserve data for only a brief time from the problem cases and pay little attention to good practices. THE HEALTH CARE FINANCING ADMINISTRATION'S STRATEGY FOR PEER REVIEW Seeing those three major problems, particularly the last in terms of the waste and inefficiency, I have been fond of telling the PROs for the last two years that we are not going to spend $300 million a year to catch a few bad guys and process gobs of medical records.
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From page 181... ...
We are developing and testing a variety of analytic tools, data bases, and hardware configurations to support the kind of transition into a more systematic approach to the assessment of quality of care. The objective of all these efforts is to equip the PROs with the skills and the tools to examine patterns of care and outcomes, to draw inferences about performance, and to share that information with the medical community and with the consumer community.
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From page 182... ...
This is the data base that everybody would have loved to have had for the last 25 years, and I guess, to put it bluntly, we are going to do it because I am sick of talking about it, and I am sick of listening to the health services research community say, "Gee, it would be great to have the data, then we could analyze the outcomes." It is not going to be perfect by any means, but we are going to use the PROs to abstract the data and develop these sizable data bases. We will be able to share them across the country, with specialty societies for standard setting, with practitioners, and with the health services research community.
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From page 183... ...
We are supplying the PROs analyses of small area variations across the country. We have contracted with the Medical College of Wisconsin and with the Wisconsin PRO to develop a data management and analysis infrastructure to enable the PROs to analyze existing large Medicare claims data bases as well as those other data bases that are emerging.
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From page 184... ...
Second, the abstracted clinical data, when linked to currently available claims data, will establish an epidemiologic data base that will enable the PROs and the Health Care Financing Administration (HCFA) to characterize patterns of care, adjusted for sociodemographic characteristics and risk-adjusted patterns of outcomes.
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From page 185... ...
to develop a data management and analysis infrastructure to enable the PROs to analyze the existing large Medicare claims data bases as well as the emerging clinical data bases. The hardware configuration has been designed, the software is being written at this time, and the testing of the system in four PROs will begin shortly.
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