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The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance (NCQA). HEDIS was designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks.
Pay for performance systems link compensation to measures of work quality or goals. Current methods of healthcare payment may actually reward less-safe care, since some insurance companies will not pay for new practices to reduce errors, while physicians and hospitals can bill for additional services that are needed when patients are injured by mistakes. [1]
Performance rating helps people do their jobs better, identifies training and education needs, assigns people to work they can excel in, and maintains fairness in salaries, benefits, promotion, hiring, and firing. Most workers want to know how they are doing on the job. Workers need performance feedback to work effectively.
Health care analytics is the health care analysis activities that can be undertaken as a result of data collected from four areas within healthcare: (1) claims and cost data, (2) pharmaceutical and research and development (R&D) data, (3) clinical data (such as collected from electronic medical records (EHRs)), and (4) patient behaviors and preferences data (e.g. patient satisfaction or retail ...
HCUP Logo. The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).
As of 2017, the largest commercial plans were Aetna, Anthem, Cigna, Health Care Service Corp, UnitedHealthcare, and Centene Corporation. [27] As of 2017, there were 907 health insurance companies in the United States, [28] although the top 10 account for about 53% of revenue and the top 100 account for 95% of revenue. [29]: 70
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