Biomedical subjects

Terry R Lied

Publications and source records attributed to Terry R Lied.

6 recordsLinked to original sources

PubMed2006

Assessment of the Medicare quality improvement organization program.

BACKGROUND: Studies have shown improvement in quality of health care in the United States. However, the factors responsible for this improvement are largely unknown. OBJECTIVE: To evaluate the effect of the Medicare Quality Improvement Organization (QIO) Program in 4 clinical settings by using performance data for 41 quality measures during the 7th Scope of Work. DESIGN: Observational study in which differences in quality measures were compared between baseline and remeasurement periods for providers that received different levels of QIO interventions. SETTING: Nursing homes, home health agencies, hospitals, and physician offices in the 50 U.S. states, the District of Columbia, and 2 U.S. territories. PARTICIPANTS: Providers receiving focused QIO assistance related to quality measures and providers receiving general informational assistance from QIOs. MEASUREMENTS: 5 nursing home quality measures, 11 home health measures, 21 hospital measures, and 4 physician office measures. RESULTS: For nursing home, home health, and physician office measures, providers recruited specifically by QIOs for receipt of assistance showed greater improvement in performance on 18 of 20 measures than did providers who were not recruited; similar improvement was seen on the other 2 measures. Nursing homes and home health agencies improved more in all measures on which they chose to work with the QIO than in other measures. Nineteen of 21 hospital measures showed improvement; in this setting, QIOs were contracted for improvement initiatives solely at the statewide level. Overall, improvement was seen in 34 of 41 measures from baseline to remeasurement in the 7th Scope of Work. LIMITATIONS: As in any observational study, selection bias, regression to the mean, and secular trends may have influenced the results. CONCLUSIONS: These findings are consistent with an impact of the QIO Program and QIO technical assistance on the observed improvement. Future evaluations of the QIO Program will attempt to better address the limitations of the design of this study.

Emergency Medical Services↗

PubMed2004

Trends in Medicaid prescribed drug expenditures and utilization.

The findings show that with the development of a multitude of safe and effective drugs during the later part of the 20th century and the beginning of the 21st century, drugs are, as never before, a true mainstay of medical treatment. CMS continues to monitor drug utilization and expenditures in all of its programs in order to ensure that care is rendered in a cost-effective manner that is beneficial to the patient. This highlight summarizes trends in drug expenditures and utilization in the Medicaid Program.

Adult↗

PubMed2004

Health status of dually eligible beneficiaries in managed care plans.

We conducted a descriptive study examining the health status of dually eligible beneficiaries using a sample from the Medicare Health Outcomes Survey (HOS), a measure of health status administered to enrollees in Medicare managed care (MMC). Overall, we found that dually eligible beneficiaries were sicker, more depressed, and reporting more pain than Medicare-only beneficiaries. Our results suggest that quality improvement initiatives that center on pain and depression management in the dually eligible population present important opportunities for collaboration between Medicare and Medicaid.

Aged↗

PubMed2004

Mental-behavioral health data: 2001 NHIS.

These data highlights are based on analysis of the 2001 National Health Interview Survey (NHIS) public use data (http://www.cdc. gov/nchs/nhis.htm). NHIS is a multi-purpose survey conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention. NHIS has been conducted continuously since 1957.

Adolescent↗

PubMed2003

Beneficiary reported experience and voluntary disenrollment in Medicare managed care.

Disenrollment rates have often been used as indicators of health plan quality, because they are readily available and easily understood by purchasers, health plans, and consumers. Over the past few years, however, indicators that more directly measure technical quality and consumer experiences with care have become available. In this observational study, we examined the relationship between voluntary disenrollment rates from Medicare managed care (MMC) plans and other measures of health plan quality. The results demonstrate that voluntary disenrollment rates are strongly related to direct measures of patient experiences with care and are an important complement to other measures of health plan performance.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed2002

Combining HEDIS indicators: a new approach to measuring plan performance.

We developed a new framework for combining 17 Health Plan Employer Data and Information Set (HEDIS) indicators into a single composite score. The resultant scale was highly reliable (coefficient alpha = 0.88). A principal components analysis yielded three components to the scale: effectiveness of disease management, access to preventive and followup care, and achieving medication compliance in treating depression. This framework for reporting could improve the interpretation of HEDIS performance data and is an important step for CMS as it moves towards a Medicare managed care (MMC) performance assessment program focused on outcomes-based measurement.

Aged↗