One of the measures used the Quality Review and Performance Improvement Team is CAHPS. What does this acronym stand for?
What is "Consumer Assessment of Healthcare Providers and Systems"?
100
Measured by the Medical Quality Audit Team, these reviews are done to see if health plans are complying with contractual provisions.
What are "Standards of Care" reviews?
100
The National Plan and Provider Enumeration System (NPPES) does this.
What is "assigns NPI numbers"?
100
The PIP Summary rating that is most preferred!
What is "Met"?
100
This team has a contract deliverable to work with FHKC on performance standards for the health plans.
What is the Quality Review and Performance Improvement team?
200
Conducted by the Medical Quality Audit Team, this activity helps Healthy Kids sample if plans are complying with HEDIS and Bright Futures Standards.
What are medical record reviews?
200
This entity certifies the software used by the Quality Review and Performance Improvement team to calculate Quality of Care measures.
NCQA
200
This entity is responsible for assisting health care providers in applying for their NPIs and updating their information in NPPES.
What is the NPI Enumerator?
200
A PIP is considered "met" if these are clearly defined, objective, and measurable.
What are "Study Indicators"?
200
Name which of the teams here today conducts phone surveys with Healthy Kids Enrollees to determine plan level satisfaction.
What is the Quality Review and Performance Improvement Team?
300
One of the backbones of both the Quality Review and Performance Improvement Team AND the Medical Quality Audit Team is HEDIS. What does this acronym stand for?
Healthcare Effectiveness Data and Information Set
300
The Medical Quality Audit team reviews ______________ processes related to quality to make sure quality is actively integrated into health care.
What is evaluation (quality evaluation processes)?
300
These improve the efficiency and effectiveness of the electronic transmission of health information
What are NPI (National Provider Identifier) Numbers?
300
These aspects make it more likely a plan will get a "met" rating on its data collection procedures. (Name one)
1)clear identification of the data to be collected
2)identification of the data sources and how and when the baseline and repeat indicator data will be collected
3)specification of who will collect the data
4)identification of instruments used to collect the data
300
This team asked some of your providers to FedEx or fax copies of enrollees' medical records this year.
What is the Medical Quality Audit Team?
400
If a child is prescribed an antibiotic within three days of being diagnosed with this, this is NOT desirable.
What is an upper respiratory infection (URI)?
400
The ICHP conducts quality certification of claims and _______ data to ensure the validity of quality of care measures.
What is encounter data?
400
This act mandated the adoption of standard unique identifiers for health care providers and health plans.
What is HIPAA?
400
This is the FHKC Committee that reviews the PIPs and decides on the direction plans should take their PIPs.
What is the Quality Committee?
400
The Quality Review and Performance Improvement Team compiles quarterly claims and encounter submission compliance information into this.
What is the "logbook"?
500
Healthy Kids enrollees.
What is "Who really benefits from all of the efforts to monitor plan and provider performance on HEDIS measures?"
500
This entity devours (in bite size pieces!) information developed by both ICHP teams when it considers funding and policy implications for upcoming years.
What is the Legislature?
500
The quantity of digits in an NPI Number
What is 10?
500
This is why (besides being required by CHIPRA to do it) FHKC requires plans to do PIPs and why we keep asking if they have worked.
What is "because it improves care to our enrollees"
500
Despite all the big words, the pages of reports, the multiple power points decks, these are the true beneficiaries of all the efforts.
What are Healthy Kids enrollees and their families?