Reference no: EM132471433

You should be familiar with quality improvement initiatives including the National Committee for Quality Assurance (NCQA) HEDIS & Quality Measurement: HEDIS Measures. (Links to an external site.) Health plans and physicians must ensure they are meeting standards set by the accreditation agencies, such as NCQA. As a physician practice manager for Dr. Jones, you have just conducted a mock survey of the patient chart data. The data shows that your physician practice is not meeting standards for two HEDIS measures below.

Using the two HEDIS measures below answer questions below. The measures are implemented in a physician practice to improve patient outcomes.

Measure 1) Persistence of Beta Blocker treatment after a Heart Attack (BPH):

Discussion 1: Assesses adults 18 years of age and older during the measurement year who were hospitalized and discharged alive with a diagnosis of acute myocardial infarction and who received persistent beta-blocker treatment for six months after discharge.

Measure 2) Smoking Cessation:

Discussion 2: Assesses current smokers seen by a physician during the year who were advised to quit, and cessation medications were recommended and discussed. Different cessation methods were discussed.

Question 1) You must describe the sources of data needed to conduct the two measures. What source would you use obtain the data? For example, if we were to look at patients receiving a beta blocker after discharge from the hospital, we would obtain data from pharmacy claims.

Question 2) Using one of the quality improvement models (i.e., Lean, PDSA, or Six Sigma), explain how you would use the model to implement one of the chosen HEDIS measures.

Question 3) Include information on how the quality initiatives chosen are linked to the rising costs of health care. Consider government mandates that have improved quality initiatives related to implementing the HEDIS measures or added to the burden of increased costs.