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Health care ratings are ratings or evaluations of health care. In the United States they have been an increasingly used tool to try to drive accountability among health care providers and in the context of classic supply / demand view of Health economics , to help health care consumers make better choices.
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.
Specifically, most ratings are determined from multivariate logistic regressions of medical outcomes at a given healthcare provider to risk-adjust the patients and 1-, 3- and 5-star awards are given to providers whose negative outcomes are worse than expected, near predicted levels, and better than expected, respectively.
Their data has impact: a nurses' union's 2011 public statements cited Becker's data to justify their demands. [7] Becker's reports on how data is used (or abused) [8] and they cite, review and analyze [9] surveys and rankings, [10] including how various subgroups of medical practitioners are affected. [11]
by health care clearinghouses in their internal files to create and process standard transactions and to communicate with health care providers and health plans; by electronic patient record systems to identify treating health care providers in patient medical records; by the Department of Health and Human Services to cross reference health ...
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An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to ...
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