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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.
Behaviorally anchored rating scales (BARS) are scales used to rate performance.BARS are normally presented vertically with scale points ranging from five to nine. It is an appraisal method that aims to combine the benefits of narratives, critical incidents, and quantified ratings by anchoring a quantified scale with specific narrative examples of good, moderate, and poor performance.
Smart Systems for Health / eHealth Ontario: Electronic health record: Ontario, Canada: Provincial government eHealth Ontario is a group of projects that replaced a previous failed project, Smart Systems for Health, which "spent $650 million but failed to produce anything of lasting value." However, in 2009 the CEO of the eHealth Ontario agency ...
In a statement on Friday, UnitedHealthcare said “highly inaccurate and grossly misleading information has been circulated about our company’s treatment of insurance claims” and that it ...
One innovation in encouraging quality of healthcare is the public reporting of the performance of hospitals, health professionals or providers, and healthcare organizations. However, there is "no consistent evidence that the public release of performance data changes consumer behaviour or improves care".
The "healthspan-lifespan gap" was largest in the U.S., as Americans live in poor health for an average of 12.4 years, compared to 10.9 years in 2000.
Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate. [1] In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($750 billion out of $2.6 trillion) in 2012.
AI can still make a positive impact on healthcare, Ransom said. For example, large language models could be used to analyze difference datasets to help predict who might need services and ...