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HEDIS (Health Plan Employer Data and Information) is a nationwide collaborative effort among employers, health plans, and physicians to monitor and compare health plan performance as specified by the NCQA (National Committee for Quality Assurance). Annually, managed care plans submit Health Plan Employer Data and Information Set (HEDIS) results to NCQA(www.ncqa.org), the National Committee on Quality Assurance, a not-for-profit organization. Effectiveness of care is measured in several catagories including: -Childhood immunization -Adolescent immunization -Cervical cancer screening -Chlamydia screening -Breast cancer screening -Comprehensive diabetes care -Beta blocker treatment after heart attack -Well child visits -Prenatal and postpartum care -Cholesterol management -Controlling hight blood pressure -EF measurement and medication doses in CHF HEDIS/QARR (Quality Assurance Reporting Requirements) Measures: One NYS Department of Health initiative utilizes HEDIS/QARR guidelines to recommend that all sexually active women between the ages of 16 and 26 have at least one test for Chlamydia each year. Most women infected with Chlamydia do not have reconizable symptoms. Such routine screening is recommended by: -US Preventive Services Task Force -AMA -ACOG -AAFP -AAP -CDC The Leapfrog Group is a consortium of Fortune 500 companies and public and private purchasers that initiated a national campaign in 2000 to recognize and reward hospitals that adopt initiatives having an effect that improves patient safety. Currently the Group recommends the following: -Computer Physician Order Entry -ICU staffing by intensivist -Evidence-based hospital referral (www.leapfroggroup.org) Many hospitals refer to Milliman General Recovery Guidelines when trying to decide about optimum hospital length of care (www.mnr.com) Monitoring hospitals for Quality Indicators orchestrated through JCAHO, CMS, NQF and others. Current key Quality of Care Measures include: 1-Care of patients with Acute MI; 2-CHF; 3-Pneumonia Components of these three catatories which are measured include: Ogygenation assessment (by ABG or pulse ox) Pneumococcal vaccination and Flu vaccine (Nov-Feb) Blood cultures w/in 24 hours and before first antibiotics First antibiotics under 8 hours of admission (but sooner is better) And antibiotics should be appropriate (as described by CMS) Smoking cessation counselling

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