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The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance (NCQA). HEDIS was designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks.
Performance is an abstract concept and must be represented by concrete, measurable goals or objectives. For example, baseball athlete performance is abstract as it covers many different types of activities. Batting average is a concrete measure of a particular performance attribute for a particular game role, batting, for the game of baseball.
Business performance management (BPM) (also known as corporate performance management (CPM) [2] enterprise performance management (EPM), [3] [4] organizational performance management, or performance management) is a management approach which encompasses a set of processes and analytical tools to ensure that an organization's activities and output are aligned with its goals.
The growth in employer-sponsored premiums as well as deductibles has led individuals and families to ration health care. High premiums and deductibles encourage individuals and families to think twice before they use health services and lessens the ability for individuals to consume other goods and services. [18] [failed verification]
Pay for performance systems link compensation to measures of work quality or goals. Current methods of healthcare payment may actually reward less-safe care, since some insurance companies will not pay for new practices to reduce errors, while physicians and hospitals can bill for additional services that are needed when patients are injured by mistakes. [1]
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
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An EIS integrates planning or budgeting with control of performance reporting, and it can be extremely helpful to finance executives. EIS focuses on financial performance accountability, and recognizes the importance of cost standards and flexible budgeting in developing the quality of information provided for all executive levels.