April 9, 2018, Salt Lake City — HealthInsight released Utah’s first public report on the quality of local primary care, that combines Medicare and commercial claims data, significantly expanding the information consumers can access about the quality of care in Utah. Published on HealthInsight’s website at https://healthinsight.org/rankings/utah-diabetes-screening, the report enables Utahns to compare comprehensive diabetes care across the state’s designated small areas (http://www.health.utah.gov/opha/IBIShelp/sarea/UtahSmallAreaInfo.pdf).
The report includes data provided by Medicare through the Qualified Entity Certification Program. The new Medicare data permitted Utah to combine commercial claims data from our All Payer Claims Database and Medicare Fee-for-Service claims data to provide measures that reflect health care quality for adult populations in Utah’s small areas.
“For first time, data that reflects the care received by all Utahns across public and private payers is publically available,” Juliana Preston, executive director at HealthInsight Utah said. “This allows consumers and patients to compare the care they receive in their community to that of other communities across the state. Patients and families, and especially those with diabetes, can use this quality information with other information to help make informed choices about their medical care and providers.”
Comprehensive diabetes measures reported this year include A1C screening and medical attention for nephropathy. The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past three months. The A1C test helps health care providers adjust an individual’s medication for optimal diabetes management. The medical attention for nephropathy measure assesses whether patients diagnosed with diabetes (Type I and Type II) have been screened or monitored for kidney disease. These National Quality Forum-endorsed measures are important because managing diabetes well can delay or prevent complications affecting the eyes, kidneys and nerves, as well as reducing risk for heart disease and stroke.
HealthInsight, a nonprofit, community-based health care consulting organization, working to improve health and health care for patients and providers, became a qualified entity (QE) in 2014 and is the only Quality Improvement Organization (QIO) that is also a QE. As a QE, HealthInsight has expertise in the following:
- Accurately calculating quality and efficiency
- Identifying the effectiveness or resource-use measures from health care claims data
- Accurately preparing performance reports on providers and suppliers
- Combining Medicare claims data with data from other sources
HealthInsight plans to expand and refine qualified entity reporting in the coming year, including alignment with a greater number of the quality measures. In addition, we plan to report quality measures that include both commercial and Medicare patients at the physician office level.
HealthInsight is a recognized leader in convening and partnering with our communities to improve health and health care by advancing quality, efficiency and value for patients and providers. HealthInsight Utah serves as a catalyst, using collaborative efforts to facilitate and promote the quality and safety of health care to achieve improved outcomes and value for all Utahns. Learn more at healthinsight.org.