Online Program

When one size doesn't fit all: Methods for assessing overall quality of healthcare services to seniors in a large and diverse Medicaid health plan using CAHPS data, 2006-2012

Tuesday, November 5, 2013

S. Rae Starr, MPhil, MOrgBehav, HealthCare Outcomes & Analysis, L.A. Care Health Plan, Los Angeles, CA
Healthcare administrators serving mixed-age populations need tools for examining the particular healthcare needs of seniors. Patient feedback is important for the design of programs and interventions to serve the Medicare population and older members in Medicaid.

Quality of care has many facets: CAHPS surveys, for example, assess over 10 dimensions of service quality. A focus on everything is a focus on nothing. Statistical tools help solve the conundrum of where to aim resources to get the best value for older patients.

The difficulty with a one-measure-fits-all approach to summarizing quality, is that different populations have competing needs, which imply tradeoffs. This study examines analytic tools for combining information from many measures, to focus on what drives seniors' ratings of healthcare quality.

(1) Study design>: The study explores statistical and algebraic methods to adaptively combine CAHPS survey measures into single scores to determine what drives seniors' ratings of quality of care and services, toward guiding improvements in access and quality.

(2) Setting: The study uses data selected from CAHPS surveys between 2006 and 2012 in a large and diverse Medicaid health plan with a growing population of Medicare patients and seniors with disabilities.

(3) Analysis: Results specific to older patients are presented, compared to quality of care received by other age groups.

(4) Uses: The briefing reports ways to adapt CAHPS surveys to measure what drives the quality of services that seniors receive; and summarizes best practices in selecting, summarizing, analyzing and reporting on how health plans and agencies serve seniors.

Learning Areas:

Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Social and behavioral sciences

Learning Objectives:
Describe the facets of quality care and services, and discuss the implications for measuring and rating services. Explain differences in health care needs for Medicaid populations with multiple age strata.. Identify tradeoffs between competing values in measuring and improving the quality of care received by seniors. Describe different approaches for creating overall measures of health care quality to guide decisions about services. Discuss the need for combined measures for reporting overall quality to seniors making choices between different sources of healthcare services. Describe key drivers of overall health care quality for older patients. Explain the uses of information from CAHPS surveys to guide the focus and design of quality improvements of value to older patients. Explain how to augment surveys to support root cause analyses of problems older patients have in getting quality services.

Keyword(s): Aging, Patient Satisfaction

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Served seven years as Senior Biostatistician at the largest U.S. public health plan, serving Medicaid and CHIP populations in an ethnically diverse urban county in the southwest United States. Managed CAHPS survey from 2006 to 2013 to obtain actionable information to guide the design of interventions to improve the quality of services and care. Designed survey questions and analytic plans for studying the needs of seniors and other special populations, to guide programs and projects.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.