Quality of Care Research

The research team at UMass Medical School's Center for Health Policy and Research has a wealth of experience conducting health care quality assessment studies for public health care organizations, such as MassHealth and the Office of Vermont Health Access.

Analysis of the Factors Influencing MassHealth HEDIS Rates

Each year, the Center for Health Policy and Research conducts a detailed analysis of select Healthcare Effectiveness Data and Information Set (HEDIS) measures to identify the member, provider, and health plan characteristics that influence HEDIS rates reported by the health plans that serve the Massachusetts Medicaid managed care population. Recent analyses found that alcohol and drug use disorders and emergency department use were associated with lower quality care and that members with higher illness burden received higher quality care in some areas. In addition, characteristics such as age, gender, disability, and type of primary care provider were also found to influence health plan rates on several quality measures.

Population Selection and Program Monitoring for Vermont’s Chronic Care Management and Care Coordination Programs

A two-year project in collaboration with the Office of Vermont Health Access also used HEDIS measures, as well as other general and disease-specific quality measures, but focused on members who suffered from one of 11 prevalent and costly chronic illnesses (asthma, diabetes, arthritis, low back pain, chronic obstructive pulmonary disease [COPD], ischemic heart disease, congestive heart failure, hypertension, hyperlipidemia, and chronic renal failure). The Center for Health Policy and Research calculated these quality measures from Vermont Medicaid claims data to monitor the quality of care provided to members enrolled in the state’s Chronic Care Management and Care Coordination programs. Both of these programs sought to reduce costs and emergency service utilization through effective disease management.

Recommended Publications

Baxter, J.D., Samnaliev, M. Clark, R.E. The quality of asthma care in adults with substance related disorders and mental illness. Psychiatric Services, 60(1): 43-49, 2009.

Clark R, Weir S, Ouellette R, Zhang J & Baxter J. (2009.) Beyond Health Plans: Behavioral Health Disorders and Quality of Diabetes and Asthma Care for Medicaid Beneficiaries. Medical Care, 47(5):545-552.

Samnaliev M, Baxter JD & Clark RE. (2009.) Asthma quality measures in five populations. Chest, 135(5): 1193-1196.

 

Key Staff

 Robin Clark Robin Clark, Ph.D.
Senior Director, Research
   

Learn More

Robin Clark
(508) 856-4226
robin.clark@umassmed.edu