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In some studies, attainment of HEDIS measures is associated with cost-effective practices or with better health outcomes. In a 2002 study, HEDIS measures "generally reflect[ed] cost-effective practices". [11] A 2003 study of Medicare managed care plans determined that plan-level health outcomes were associated with HEDIS measures. [12]
The RAND Health Insurance Experiment (RAND HIE) was an experimental study from 1974 to 1982 of health care costs, utilization and outcomes in the United States, which assigned people randomly to different kinds of plans and followed their behavior.
Such large-scale systems are only at present evident in the field of mental health services, and only well developed in two locations: Ohio [8] and Australia, [9] even though in both of these data on context and interventions are much less prominent than data on outcomes. The major challenge for health outcomes measurement is now the ...
Clinical outcomes, such as longer survival, are difficult to measure, so pay for performance systems usually evaluate process quality and efficiency, such as measuring blood pressure, lowering blood pressure, or counseling patients to stop smoking. This model also penalizes health care providers for poor outcomes, medical errors, or increased ...
Health care quality is the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes. [2] Quality of care plays an important role in describing the iron triangle of health care relationships between quality, cost, and accessibility of health care within a community. [3]
Health insurance coverage is provided by several public and private sources in the United States. Analyzing these statistics is challenging due to multiple survey methods [13] and persons with multiple sources of insurance, such as those with coverage under both an employer plan and Medicaid.
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