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On October 22nd the National Committee for Quality Assurance (NCQA) held a news conference in Washington, DC to release “The State of Health Care Quality: 2009.” The report is produced annually to monitor performance trends over time, track variations in patterns of care and provide recommendations for future quality improvement. It also provides an exclusive look at how well the health system performed over the past year in key areas of care and service. Data is drawn from audited data conveyed to NCQA through its Health Care Effectiveness Data and Information Set (HEDIS®) -- the most widely used performance measurement tool in health care -- as well as the Consumer Assessment of Healthcare Providers and Systems (CAHPS®).
Dr. Nancy Van Vessem represented Capital Health Plan at the press conference, which focused on the achievements of a few notable health plans in the country. She highlighted Capital Health Plan’s achievements in Diabetes and Coronary Heart Disease Relative Resource Use (RRU) measures. NCQA will start publicly reporting HEDIS® RRU measures in 2010. These measures, unlike previous HEDIS® measures, assess the efficiency of care delivered by health plans for certain chronic diseases. In general, CHP members require less “rescue” such as inpatient admission and emergency room visits than members in other health plans.
Dr. Van Vessem emphasized that the long-term success of CHP is rooted in its high member satisfaction, high levels of trust, and low disenrollment. This means members with diabetes and coronary heart disease have been involved with local physicians and disease management programs over many years. They have fewer gaps in care attributed to a consistent approach to chronic disease and stable benefits.
“At Capital Health Plan we encourage every member to have a primary care physician. Our goal is to help the physicians manage the chronic disease of their patients,” said Dr. Van Vessem. One of the newest enhancements is that primary care physician offices can access its patients’ information related to gaps in care for a variety of quality measures via CHPConnect. This collaboration between Capital Health Plan, physicians and members has led to continued success measured by consistently excellent results on quality and member satisfaction scores. Now, that success has continued with notable performance on relative resource use measurements.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).