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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.

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
News Release
Despite Push to Reward Physicians for Quality and Value, Most Health Systems Base Pay on Volume
Despite efforts by insurance companies and other payers to move toward compensating physicians based on the quality and value of care they provide, most physicians employed in group practices owned by health systems are paid primarily based on the volume of care they provide.
Jan 28, 2022

Explore Health Care Quality Measurement

Journal Article
Summary of the 2020 AHRQ Research Meeting on 'Advancing Methods of Implementing and Evaluating Patient Experience Improvement Using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Surveys'
The Agency for Healthcare Research and Quality held a research meeting on using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data for quality improvement (QI) and evaluating such efforts. This article summarizes the meeting.
Dec 7, 2022
Journal Article
Reasons Primary Care Practices Chose Patient Experience Surveys During Patient-Centered Medical Home Transformation
In 2008–2017, 15–18% of U.S. primary care practices sought or maintained patient-centered medical home recognition. We interviewed a sample of 105 of these practices to determine why patient experience surveys were chosen.
Dec 7, 2022
Journal Article
A Systematic Review of Strategies to Enhance Response Rates and Representativeness of Patient Experience Surveys
The objective of this paper is to review evidence on survey administration strategies to improve response rates and representativeness of patient surveys.
Nov 3, 2022
Journal Article
Association Between Hospital-Physician Vertical Integration and Medication Adherence Rates
Increases in vertical integration were not associated with changes in medication adherence rates. However, adherence rates after vertical integration declined for non-Whites, patients over 80 years old, and patients with greater comorbidities.
Oct 28, 2022
Journal Article
Practices and Changes Associated With Patient-Centered Medical Home Transformation
Evidence shows that leaders who implement the patient-centered medical home care model encounter challenges in driving change. Understanding which changes and quality improvement practices further implementation is essential.
Oct 27, 2022
Journal Article
Using CAHPS Patient Experience Data for Patient-Centered Medical Home Transformation
We interviewed 105 practice leaders from 294 sampled practices and used content analysis to identify themes about uses of patient experience data for practice improvement during PCMH transformation.
Oct 27, 2022
Journal Article
Association of Medicare Advantage Premiums With Measures of Quality and Patient Experience
This population-based cross-sectional study found that although quality of care and patient experience were slightly higher with higher-premium plans, quality varied widely within each premium category.
Oct 27, 2022
Journal Article
Usefulness of Child HCAHPS Survey Data for Improving Inpatient Pediatric Care Experiences
We surveyed children's hospital leaders and staff about their use of Child HCAHPS for QI, including measures from other studies. We compared scale and item means for leaders and staff and compared means to other studies.
Oct 27, 2022
Journal Article
What Parents Have to Say: Content and Actionability of Narrative Comments from Child HCAHPS Survey
The purpose of this paper is to examine the content and actionability of written comments from parents and guardians on the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) survey.
Oct 27, 2022
Journal Article
Incorporating the Patient and Caregiver Voice in Palliative Care Quality Measure Development
As part of a national effort to develop palliative care quality metrics for use in accountability programs, we sought to develop survey items assessing patients' experiences of outpatient palliative care, incorporating the patient's voice.
Oct 24, 2022
Journal Article
Playing Defense? Health Care in the Era of Covid
This paper presents evidence that the quality of health care interactions changed in important ways during the early months of the Covid-19 pandemic.
Jul 28, 2022
Report
RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, February 7, 2022 Meeting
On February 7, 2022, the RAND Corporation convened a Technical Expert Panel web meeting to gather input about the potential development of a measure to capture value-based care arrangements Medicare Advantage organizations have with their contracted providers.
Jun 17, 2022
Journal Article
Spread Tools: A Systematic Review of Components, Uptake, and Effectiveness of Quality Improvement Toolkits
The objective was to conduct a systematic review of toolkit evaluations intended to spread interventions to improve healthcare quality. We aimed to determine the components, uptake, and effectiveness of publicly available toolkits.
Jun 7, 2022
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
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

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RAND Topic:
Health Care Quality Measurement

Research conducted by

Researcher Spotlight

Susanne Hempel

Director, Southern California Evidence-based Practice Center

Susanne Hempel is an adjunct behavioral scientist at the RAND Corporation. She is the director of the Southern California Evidence-based Practice Center (EPC), leading contracts for the Agency for Healthcare Research and Quality (AHRQ) and other federal agencies, and she holds an indefinite…
Maria DeYoreo

Codirector, RAND Center for Causal Inference

Maria DeYoreo is a statistician at the RAND Corporation and codirector of the Center for Causal Inference. Her methodological interests include Bayesian modeling, mixed and random effects modeling, Bayesian nonparametrics, missing data imputation, data fusion, and causal inference. DeYoreo's…

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