Performance Measures and Conditions
HMO Reports
- Appropriate Care
- Customer Satisfaction
- Diabetes
- Medical Care
- Mental Health
- Monthly Premiums
- Ongoing Care
- Provider Network
- Staying Healthy
- Youth Care
- Youth Wellness
Appropriate Care
- Appropriate medications for adults with asthma
- Appropriate medications for adults with rheumatoid arthritis
- Appropriate testing for chronic obstructive pulmonary disease
- Appropriate treatment of adults with bronchitis
Customer Satisfaction
- Adult access to care (20-44)
- Adult access to care (45-64)
- Claims processing
- Customer service
- Getting care quickly
- Getting needed care
- Health plan rating
- Overall Rating of Healthcare
- Provider communication
Diabetes
- Control of blood sugar for people with diabetes
- Control of cholesterol for people with diabetes
- Control of high-blood pressure for people with diabetes
- Eye exams for people with diabetes
- Testing for kidney damage for people with diabetes
Medical Care
- Appropriate medications for adults with asthma
- Beta blocker after a heart attack
- Persistence of beta blocker use
- Testing for chlamydia in young adults
- Use of imaging studies for low back pain
Mental Health
- Antidepressant medication management: acute phase treatment
- Antidepressant medication management: ongoing phase treatment
- Antidepressant medication management: visits to providers
- Follow-up after hospitalization for mental illness (within 30 days)
- Follow-up after hospitalization for mental illness (within one week)
Monthly Premiums
- HMO Standard Premium individual
- HMO Standard Premium family
Ongoing Care
- Annual monitoring for all patients on ongoing medications
- Annual monitoring for patients on ACE inhibitors or ARBs
- Annual monitoring for patients on anticonvulsants
- Annual monitoring for patients on digoxin
- Annual monitoring for patients on diuretics
Provider Network
- Board certified ob/gyns
- Board certified pediatric specialists
- Board certified physician specialists
- Board certified physicians
- Rating of your personal doctor or nurse
- Rating of your specialist physician
Staying Healthy
- Advising smokers to quit
- Control of heart patient's cholesterol levels
- Control of high-blood pressure
- Early prenatal care
- Postpartum care
- Testing for cervical cancer
- Testing for breast cancer
- Testing for colorectal cancer
Youth Care
- Appropriate medications for children with asthma
- Appropriate testing for children with sore throats
- Appropriate use of antibiotics for children with colds
- Follow-up care for children beginning ADHD medication.
Youth Wellness
- Immunization for adolescents
- Immunizations for children
- Testing for chlamydia in adolescents
Hospital Reports
- Appropriate Care
- Heart Care
- Mother/Baby
- Other Conditions
- Other Procedures
- Patient Safety
- Patient Satisfaction
Appropriate Care
Appropriate Care
| Overall appropriate care | |
|---|---|
| Overall Heart Attack Care (composite score) Overall Heart Failure (composite score) Overall Pneumonia Care (composite score) Overall Surgical Infection Prevention (composite score) |
AMI-1, AMI-2, AMI-3, AMI-5 and AMI-6 HF-1, HF-2 and HF-3 PN-1, PN-2 and PN-5b SCIP-Inf-1 and SCIP-Inf-3 |
Heart Care
Angioplasty
| Mortality | Length of stay, Charges |
|---|---|
| AHRQ Inpatient Mortality | Number of Patients Average Stay Average Charges |
Chest Pain
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges Medicare Payments |
Coronary Artery Bypass Graft
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Heart Attack
| Mortality | Appropriate care | Length of stay, Charges |
|---|---|---|
| AHRQ Inpatient Mortality Medicare 30-Day Mortality |
Aspirin given on arrival Beta blocker given on arrival Smokers advised to quit Medications for LVSD prescribed at discharge Aspirin prescribed at discharge Beta blocker prescribed at discharge |
Number of Patients Average Stay Average Charges Medicare Payments |
Heart Failure
| Mortality | Appropriate care | Length of stay, Charges |
|---|---|---|
| AHRQ Inpatient Mortality Medicare 30-Day Mortality |
HQA Left Ventricular Function Assessed HQA Medications for LVSD Prescribed at Discharge HQA Smokers Advised to Quit HQA Written Instructions Given at Discharge |
Number of Patients Average Stay Average Charges Medicare Payments |
Mother/Baby
Cesarean Section
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Normal Neonatal Care
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Vaginal Delivery
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Other Conditions
Asthma
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Chronic Obstructive Pulmonary Disease
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Depressive Neuroses
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Diabetes
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges Medicare Payments |
Kidney and Urinary Tract Infections
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Pneumonia
| Mortality | Appropriate care | Length of stay, Charges |
|---|---|---|
| AHRQ Inpatient Mortality Medicare 30-day Mortality |
Appropriate initial antibiotic selected Initial antibiotic given quickly Blood oxygen level assessed Blood culture performed Smokers advised to quit Pneumonia Patients Assessed and Given Influenza Vaccination Pneumococcal vaccine given at discharge |
Number of Patients Average Stay Average Charges |
Renal Kidney Failure
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Septicemia
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Stroke
| Mortality | Length of stay, Charges |
|---|---|
| AHRQ Inpatient Mortality | Number of Patients Average Stay Average Charges |
Other Procedures
Appendectomy
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Chemotherapy
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Gall Bladder Surgery
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges Medicare Payment |
Hand and Wrist Procedure
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Hip Replacement
| Mortality | Length of stay, Charges |
|---|---|
| AHRQ Inpatient Mortality | Number of Patients Average Stay Average Charges Medicare Payment |
Hysterectomy
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges Medicare Payment |
Obesity Procedures
| Length of stay, Charges |
|---|
| Number of Patients Average Stay Average Charges |
Patient Safety
AHRQ Patient Safety
| Safety Measures |
|---|
| Death in low mortality DRGs Failure to rescue Foreign body left in during procedure Iatrogenic pneumothorax Birth trauma - injury to neonate Accidental puncture and laceration Postoperative pulmonary embolism or deep vein thrombosis Postoperative wound dehiscence in abdominopelvic surgical patients Transfusion reaction |
Leapfrog Survey
| Safety Measures |
|---|
| Computerized Order Entry ICU Staffing Safe Practices |
Surgical Infection Prevention
| Appropriate care |
|---|
| Appropriate antibiotic Pre-surgery antibiotics Post-surgery antibiotics Blood clot prevention ordered Blood clot prevention received |
Patient Satisfaction
HCAHPS
| Patient Experience |
|---|
| Doctors always communicated well Nurses always communicated well Patients always received help as soon as they wanted Patients who gave rating of 9 or 10 Staff always explained medicine Always quiet at night Pain was always well controlled Patients would always recommend the hospital Room was always clean Staff gave patients information on recovery at home |
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