Provider Quality and Efficiency Measurement

With growing concerns about healthcare quality and cost across our nation, regionally based stakeholders are implementing local efforts to measure and report on the performance of providers in their communities. Truven Health is at the forefront of partnering with these health information collaboratives to ensure their success.

 

Our Solutions

Our independence, expertise, and experience benefit our health information collaborative customers in three critical areas:

  • Building collaborative partnerships
  • Managing large healthcare datasets
  • Measuring and reporting provider performance
Building Collaborative Partnerships

As a neutral third party, Truven Health Analytics is ideally positioned to build collaborative partnerships, both at the start and throughout the implementation process. Truven Health maintains a multi-market presence, with a broad customer base that includes:

  • Industry-leading employers
  • National and regional health plans
  • The Centers for Medicare and Medicaid Services
  • State Medicaid programs
  • Health systems and hospitals
  • Through these existing customer relationships, we have developed an in-depth understanding of the needs and interests of these myriad groups.
Integrated Healthcare Association (IHA) Pay for Performance (P4P) Program

Truven Health Analytics has assisted the IHA in the development of an Efficiency Domain for incorporation into its P4P program, including the identification and testing measures that are used to reward providers. Truven Health Analytics currently generates a diverse set of hospital- and pharmacy-related Appropriate Resource Use measures for more than 200 California physician organizations. The measures are based on integrated claims data from seven health plans that represent six million lives.

Managing Large Healthcare Datasets

Truven Health has more than 25 years of experience developing healthcare data warehouses and supporting our customers' analytic goals. We have worked with virtually all types of healthcare data, including medical claims and encounters, facility, pharmacy, and lab results data. We also offer these value-add tools for use with our customers' data:

Disease staging and risk adjustment methodologies to account for patients' specific disease severity when calculating cost of care measures

Medical Episode Grouper® (MEG) to classify medical claims into specific disease episodes for quality and efficiency reporting

Measuring and Reporting Physician Performance

We calculate quality and efficiency measures, reporting results at the physician and practice levels. Truven Health maintains an extensive quality measures library, including all of the major nationally endorsed quality measures. We created the Physician Performance Assessment™ (PPA), which delivers easy-to-read, customizable performance information that can be used by health information collaboratives to provide physicians direct access to their performance results. Features include:

  • Graphical presentation for readily understandable feedback to physicians
  • Separate displays of physician effectiveness and efficiency metrics
  • Combined physician performance results
  • Individual physician performance changes over time
  • Peer group performance
  • Drill-down capabilities to allow physicians to view the individual patient-level detail underlying the reported measures

Our Experts