HCA 375 Week 3 Discussion 1, CQI Models
CQI Models. After reading Chapter 1 through 4, you should be familiar with quality improvement initiatives including NCQA’s HEDIS® measures. Health plans and physicians must ensure they are meeting standards set by the accreditation agencies, such as NCQA. As a physician practice manager for Dr. Jones, you have just conducted a mock survey of the patient chart data. The data shows that your physician practice is not meeting standards for two HEDIS® measures.
- Choose two HEDIS® measures (from the list below either a, b, c, d, e or f) that must be …..in a physician practice to improve patient outcomes.
- Describe-the sources of data needed to conduct the two measures.
- Using-one of the quality improvement models (Lean, PDSA, or Six Sigma), explain how you would use the model to implement the two chosen HEDIS® Measures.
HCA 375 Week 3 Discussion 2, Mandates and Cost
Mandates and Cost. The Department of Health and Human Services has oversight of several agencies (i.e., FDA, CDC, AHRQ, NIH, CMS) that regulate health care in the United States. Regulation encompasses insurance plans, cost, research, safety, all in the name of delivering quality care in a cost effective manner. These agencies are responsible for monitoring compliance and enforcing legislative mandates. However, the debate continues on government regulation and its effect on ensuring quality care. After completing this week’s reading, review the following articles …..below, which were …..11 years apart. Analyze the cost- quality paradigm noted in the articles. Considering the many governmental mandates and regulations to reduce costs and ensure the delivery of quality care that have been implemented over the years, discuss your opinion regarding why costs have continued to rise without improving quality. List two examples that illustrate your point.
· DHHS Article related to Cost and Quality (2002)
· Institute of Medicine article (2013)
HCA 375 Week 3 Quiz (15 Question and Answers)