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ce.effectivehealthcare.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-pediatric-safety-2.html
August 01, 2023 - Data
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All-Payer Claims … symptoms are often attributed to constipation. 19-21
Pediatricians are aware of pediatric malpractice claims … appendicitis, along with meningitis and pneumonia, are among the most frequent conditions resulting in closed claims
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/exh3-1.html
October 01, 2014 - Data
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All-Payer Claims … Text Box 2
Identifying and Stratifying Members
Claims Data.
Risk Stratification.
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ce.effectivehealthcare.ahrq.gov/patient-safety/reports/engage/gaps.html
March 01, 2017 - Data
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All-Payer Claims … practices. 265 Another surrogate measure of safety has been through the evaluation of malpractice claims … measures are implemented to scale, surrogate measures of patient safety such as patient satisfaction and claims
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ce.effectivehealthcare.ahrq.gov/news/newsroom/case-studies/coe0602.html
October 01, 2014 - Data
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All-Payer Claims … explore this issue further among CAQH's member health plans, CAQH conducted its own research based on claims
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ce.effectivehealthcare.ahrq.gov/policymakers/chipra/cpcf-form1.html
July 01, 2018 - Data
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All-Payer Claims … Administrative Data (e.g., claims data)
2. Paper Medical Record
3.
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ce.effectivehealthcare.ahrq.gov/programs/index.html?page=3
March 27, 2024 - Data
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All-Payer Claims … This page has links to quality improvement measurement, tools, and information, including All-Payer Claims
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ce.effectivehealthcare.ahrq.gov/es/programs/index.html?page=3
April 24, 2024 - Data
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All-Payer Claims … This page has links to quality improvement measurement, tools, and information, including All-Payer Claims
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/chipra-medical-home-academyhealth.pdf
December 12, 2015 - Data
• MassHealth (Medicaid) claims, encounter, and
enrollment data, extracted from MMIS data
warehouse … Follow-up: July-December 2013 (overlaps end of LC)
• Exclusions:
Children enrolled but with no claims … modified to better specify complexity of chronic disease in
pediatric population
• Uses three-year claims
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ce.effectivehealthcare.ahrq.gov/ncepcr/research-transform-primary-care/transform/cost/guide.html
October 01, 2015 - Data
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All-Payer Claims … Data sources can include insurance claims data, general ledger data (e.g., from a staff model health … It is important to note that claims data reflect the costs and savings experienced by insurers. … considerations for gross-costing methods include:
These methods require access to general ledger or claims … Analysis of claims data may not fully reflect the costs of PCMH transformation efforts incurred by clinics
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ce.effectivehealthcare.ahrq.gov/ncepcr/reports/cost-guide/practical-guide.html
February 01, 2017 - Data
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All-Payer Claims … Data sources can include insurance claims data, general ledger data (e.g., from a staff model health … It is important to note that claims data reflect the costs and savings experienced by insurers. … considerations for gross-costing methods include:
These methods require access to general ledger or claims … Analysis of claims data may not fully reflect the costs of PCMH transformation efforts incurred by clinics
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ce.effectivehealthcare.ahrq.gov/ncepcr/care/coordination/atlas/chapter6s.html
June 01, 2014 - Data
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All-Payer Claims … are referred to such a program. 1
Format/Data Source: This process measure requires administrative claims … event who had a follow-up outpatient encounter within 14 days. 1
Format/Data Source: Electronic claims … in the specified categories. 1
Format/Data Source: This process measure requires administrative claims … all of the specified elements. 1
Format/Data Source: This process measure requires administrative claims
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ce.effectivehealthcare.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/supplhighlight02.html
May 01, 2013 - Data
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All-Payer Claims … evaluation team considered the design of each State’s demonstration project, the potential for obtaining claims … worked with the demonstration States to determine whether they would be able to contribute appropriate claims … Among the States contributing claims data to the analysis, three were using the NCQA tool to measure … Collection in the CHIPRA Quality Demonstration Grant Program Medical Home Initiatives State Providing claims
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patientsafetyculture/pharmacy/pharmwebinar/amermanslides.pdf
May 12, 2014 - Standardized processes
– E.g., perpetual inventory, patients calling their physician,
deleting rejected claims
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-145-fullreport.pdf
July 01, 2016 - Administrative data (e.g., claims data). … Treatment outcomes with methylphenidate
formulations among patients with ADHD: retrospective claims … claims, was used to iteratively
test the enhanced ADHD Follow-up Care measure and assess reliability … Administrative Claims Data: The data elements required for this measure currently exist at this
time … The first limitation is that this measure uses administrative claims data and is therefore subject to
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ce.effectivehealthcare.ahrq.gov/news/blog/ahrqviews/ahrq-2024-proposed-budget.html
March 01, 2023 - Data
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All-Payer Claims … Human Services (HHS) efforts to coordinate and align ongoing state-level efforts to develop all-payer claims
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ce.effectivehealthcare.ahrq.gov/news/blog/ahrqviews/opportunity-improve-healthcare.html
May 01, 2022 - Data
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All-Payer Claims … $5 million to create an all-payer claims database.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/overview/background/measures-AC-2.pdf
December 16, 2010 - Denominator Exclusions: Exclude claims/encounters with more than one
diagnosis
D.
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/manapb17.html
December 01, 2017 - Data
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All-Payer Claims … , added costs of medical treatment, and an increase in the nursing facility's costs to settle legal claims
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ce.effectivehealthcare.ahrq.gov/patient-safety/quality-resources/tools/chtoolbx/toolcon/index.html
June 01, 2020 - Data
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All-Payer Claims … Envelope—But Not Too Hard
Learn and Use the "Typical" Data Sources
Consider Using Encounter or Claims
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ce.effectivehealthcare.ahrq.gov/cahps/item-sets/index.html
April 01, 2024 - Data
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All-Payer Claims … For example, supplemental items ask about experiences with claims processing, health information technology