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Report Methodology

Quality Measurement

Improving healthcare quality is a priority for providers at all levels of the healthcare continuum, including individual providers and facilities. Quality measures are tools that can be used to quantify or evaluate improvement in healthcare related processes, outcomes, and beneficiary perceptions of care received. This report includes results from the Healthcare Effectiveness Data and Information Set (HEDIS®) quality measures (13), the Agency for Healthcare Research and Quality (AHRQ) quality indicators, the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, the Youth Risk Behavior Survey (YRBS), and administrative reports. Each measure set evaluated a distinct area of the healthcare establishment (9).

The HEDIS measures are a set of standard health care performance measures created and maintained by the National Committee for Quality Assurance (NCQA). They are used to collect and compare information across health plans and states about the quality of care and services provided to healthcare beneficiaries. HEDIS measures included in this report are indicators of effectiveness of, and access to, care. This report summarizes the performance of Arkansas Medicaid beneficiaries on a subset of HEDIS measures for recipients in the primary care case management (PCCM) population. PCCM recipients are assigned a primary care provider (PCP) responsible for the delivery of appropriate and timely care.

The AHRQ quality indicators presented in this report include a subset of the Prevention Quality Indicators (PQIs). The PQIs are a set of measures that when used as intended, can identify conditions where good outpatient care can avert the need for hospitalization, facilitate the avoidance of complications, or deter more severe disease. The PQIs in this report focus on conditions associated with a large number of preventable hospital admissions, including diabetes, COPD/asthma, and heart failure.

The CAHPS Medicaid Adult and Child Beneficiary Satisfaction surveys ask consumers and patients to report on and evaluate their experiences with health care. These measures represent a key indicator of patient satisfaction.

The Youth Risk Behavior Surveillance System (YRBSS) conducts the Youth Risk Behavior Survey (YRBS). YRBS is a biennial, national survey of students (grades nine through 12) in the United States that provides data on health risk behaviors, including behaviors that contribute to injuries and violence, alcohol or other drug use, tobacco use, sexual risk behaviors, unhealthy dietary behaviors, and physical inactivity. YRBS also measures the prevalence of obesity and asthma among youth and young adults. These measures represent the health and behaviors of adolescents in Arkansas.

How to Read This Report

As a web-based publication, this report incorporates navigation features that allow the reader to move seamlessly between report sections. Left and right navigation bars can be used to jump between sections of this online report. The right navigation bar allows readers to review the background, methodology, and citations while the left navigation bar links to the various results sections.

Throughout the report, pop-up windows with measure definitions will appear when the user’s mouse hovers over the measure icon next to the measure name. Measure results show the current year’s rates compared to those for a similar population from previous years. Arrows are used to indicate a change in the measure between SFY 2013 and SFY 2014, with an asterisk identifying whether the change in rate was statistically significant.

National NCQA Medicaid HEDIS benchmarks are shown for comparison between rates in Arkansas and rates in the United States as a whole. Historically, NCQA’s benchmarked rates for managed care plans have been higher than those of the fee-for-service model used in Arkansas, but they remain comparable. For results presented in charts and figures, the HEDIS 2014 national Medicaid 50th percentile is indicated in the chart (usually with a horizontal line). For results presented in tables, the rates will be indicated as above or below the HEDIS 2014 national Medicaid 50th percentile.

Data Collection

The data included in this report represent a variety of healthcare-related topics, data sources, and data collection methodologies.

HEDIS measures: With the exception of the immunization measures, data collected for this report were based solely on claims data submitted to the Division of Medical Services. Immunization findings were produced using a hybrid methodology, meaning the claims data were supplemented with information obtained from beneficiaries’ medical records.

AHRQ Quality Indicators: These measures are calculated using Medicaid claims.

Medicaid Adult and Child CAHPS: These patient-centered surveys are conducted every two years to provide information about child and adult members’ experiences and attitudes related to the services received. Surveys are administered using a three-wave mail methodology wherein up to three questionnaires and two reminder postcards are mailed to the member to maximize survey response.

Youth Risk Behavior Survey: This survey is collected every other year on a subset of high school students (grades nine through 12) across the United States and the U.S. territories. Surveys are voluntary and anonymous. The self-administered questionnaires are completed during one class period on a computer-scannable answer sheet or booklet. The results presented in this report are from the most recent survey, which was conducted in 2013.

Limitations

The results of the HEDIS measures in this report are limited to recipients in the primary care case management (PCCM) population and may not be generalizable to other Arkansas Medicaid populations. The data used to calculate the HEDIS measure rates were primarily collected from fee-for-service administrative data sources, including enrollment and claims data. These administrative data sources do not include medical record review, which may limit the type of information that can be included. For example, items such as the administration of a depression screening may be indicated in a medical record, but may not be indicated in claims. This limits the type of measures that can be included in this report.

Results from surveys are subject to nonresponse bias, meaning that participants who choose to respond to a survey may be different from those who do not respond. For example, participants who are particularly happy or disappointed with the care they received may be more likely to respond to a survey than those who feel neutral. Surveys are also subject to recall bias, wherein the respondent may not clearly recall the events about which he or she is being asked.

Citations

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