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Health Care Quality Measurement

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Increasingly, tools and surveys are employed to determine current and optimal levels of health care service and performance, and ultimately to improve the levels for each. RAND helps policymakers, health care leaders, and practitioners determine cost-effective and accurate ways to measure the quality of health care being provided, and then recommends ways to improve the level of health care quality.

News Release

Low-Value Care Among Medicare Recipients Drops Only Marginally Despite Effort to Curb Practices

Feb 16, 2021

Examples of low-value health care include prescribing opioids for acute back pain and antibiotics for upper respiratory infections. Despite efforts to better educate clinicians and discourage wasteful care, spending on such services among Medicare recipients dropped only marginally from 2014 to 2018.
Essay

A New Way to Capture the Patient Experience

May 2, 2019

Researchers have developed a more effective and reliable way for patients to provide narrative feedback about the care they receive. When the right questions are asked, patients' answers can help health care providers better understand the patient experience and learn how they could improve.

Explore Health Care Quality Measurement

Journal Article

Quality Framework for Remote Antenatal Care: Qualitative Study with Women, Healthcare Professionals and System-Level Stakeholders

This study offers a provisional framework that can help in structuring thinking, policy and practice. By outlining the range of domains relevant to remote antenatal care, this framework is likely to be of value in guiding policy, practice and research.

May 17, 2022
Research Brief

Standards for Delivering High-Quality Care to Veterans with Invisible Wounds

Depression, PTSD, traumatic brain injury, and substance use disorders interfere with veterans' employment, family life, community engagement, and well-being. There are effective treatments but also barriers to accessing them. A set of standards can help identify providers who serve veterans and deliver high-quality care.

May 9, 2022
Report

Recommended Standards for Delivering High-Quality Care to Veterans with Invisible Wounds

The authors identified ten standards for the delivery of high-quality care for veterans with posttraumatic stress disorder, depression, substance use disorders, and mild traumatic brain injury.

May 9, 2022
Journal Article

Physician Compensation Arrangements and Financial Performance Incentives in US Health Systems

This study was a cross-sectional mixed-methods analysis of in-depth multimodal data from 31 POs affiliated with 22 purposefully selected health systems in 4 states. Data were analyzed from June 2019 to September 2020.

Feb 8, 2022
Journal Article

Adjusting for Patient Characteristics to Compare Quality of Care Provided by Serious Illness Programs

To ensure fair comparison of serious illness programs, quality measure scores should be case-mix adjusted for variables that influence patients' reports about care quality, but are not under the control of the program administering care.

Feb 4, 2022
Journal Article

Understanding What Works: Measuring and Monitoring Quality in Medi-Cal's Home and Community-Based Services

This issue brief describes challenges and opportunities related to measuring, reporting, and monitoring the quality of HCBS sponsored by Medi-Cal.

Jan 26, 2022
Journal Article

Reliable and Valid Survey-Based Measures to Assess Quality of Care in Home-Based Serious Illness Programs

Our analyses provide evidence of the feasibility, reliability, and validity of proposed survey-based measures to assess the quality of home-based serious illness care from the perspective of patients and their families.

Jan 25, 2022
Commentary

Does Vertical Integration Improve or Imperil U.S. Health Care?

Health care consolidation is endemic across the United States. With consolidation has come public attention and regulatory scrutiny. Unfortunately, evidence is accumulating that health care consolidation is harming competition in the U.S. health care market, while neither reducing costs nor improving care.

Nov 16, 2021
Report

Readiness of Soldiers and Adult Family Members Who Receive Behavioral Health Care: Identifying Promising Outcome Metrics

To inform the U.S. Army's efforts to monitor and improve outcomes, the authors of this report aimed to identify promising metrics to assess readiness among soldiers and adult family members who receive behavioral health care.

Nov 2, 2021
Journal Article

Adjusting Medicare Advantage Star Ratings for Socioeconomic Status and Disability

We examine the impact of socioeconomic status and disability adjustments on Medicare Advantage plans' and prescription drug plans' contract star ratings.

Oct 29, 2021
Journal Article

Alignment Between Objective and Subjective Assessments of Health System Performance: Findings From a Mixed-Methods Study

The article examines whether subjective performance assessments from health system executives match objective performance assessments and qualitatively explores ways to achieve high performance.

Sep 15, 2021
Research Brief

New Patient-Centered Quality Measures for Office-Based Palliative Care

This research brief describes the development and testing of two patient-centered quality measures of symptom management and communication and provides considerations for palliative care providers that plan to use them.

Sep 13, 2021
Report

MACRA Palliative Care Quality Measure Development—Testing Summary Report: Measure Name: Receiving Desired Help for Pain

The authors describe the results of their national beta field test for a performance measure designed to assess the extent to which patients who used ambulatory palliative care received the help they wanted for their pain.

Sep 3, 2021
Report

MACRA Palliative Care Quality Measure Development—Testing Summary Report: Measure Name: Feeling Heard and Understood

The authors describe the results of their national beta field test for a performance measure designed to assess the extent to which patients who used ambulatory palliative care felt heard and understood by their palliative care provider and team.

Sep 3, 2021
Report

RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, May 5, 2021 Meeting

The RAND team gathered input from experts about stratified reporting by Part D low-income subsidy (LIS) and dual eligibility (DE), and disability and assessing social risk factors of Medicare Advantage (MA) and Part D contract beneficiaries.

Aug 5, 2021
Journal Article

Developing Health Equity Measures

This work identified existing approaches to health equity measurement and evaluated those approaches using input from an expert panel.

May 21, 2021
Journal Article

Examining the Business Case for Patient Experience: A Systematic Review

This article reviews the literature on associations between patient experience and business outcomes, including patient allegiance and retention, complaints, lawsuits, provider job satisfaction, and profitability.

May 21, 2021
Journal Article

Clinical Governance and Continuous Quality Improvement in the Veterinary Profession: A Mixed-Method Study

96% of the veterinary profession agrees that Quality Improvement (QI) improves veterinary care. A lack of time, know-how and organisational support were among the barriers preventing its adoption in practice.

May 14, 2021
Journal Article

Assessment of Variation in Electronic Health Record Capabilities and Reported Clinical Quality Performance in Ambulatory Care Clinics, 2014–2017

Between 2014 and 2017, clinics with EHRs having greater capabilities had better quality measures than other clinics, but clinics that gained EHR capabilities during this time had smaller increases in quality that were not statistically significant.

May 4, 2021
Research Brief

Improving Behavioral Health Care for Remote Service Members: Three Key Priorities

Service members who are geographically remote from a military treatment facility may face unique challenges accessing high-quality behavioral health care. RAND research identified three key priority areas for the U.S. Department of Defense.

Apr 5, 2021

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RAND Topic:
Health Care Quality Measurement

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