Building and Maintaining Health Plan Performance Information – California Cooperative Healthcare Reporting Initiative (CCHRI)

Problem: For purchasers, their employees and consumers in general to make the best health plan and provider purchasing decisions, they need information on comparative performance. Standardized and comparable information can be a tool for consumers, plans and providers—used to drive quality improvement at all levels. In the past, some health plans created their own measurement systems or collected information but did not publicly report it, resulting in confusing and even conflicting information.

• A single process for collection and analysis.
• Use of an independent and impartial third party to assemble and analyze the data.
• Standardized performance reporting definitions and an audit of all measures.

The project is supported by fees from participating health plans, with supplemental funding from the PBGH Quality Improvement Fund.

Impact: CCHRI's voluntary collaborative approach has helped drive quality measurement and improvement in California. Participating health plans provide health benefits to nearly 95 percent of the state's commercial enrollment. CCHRI benefits PBGH member employees and California consumers by assuring that plans can be compared on an "apples-to-apples" basis. This approach has also benefited the health plans by streamlining and reducing the burden for collection and reporting of the information. Publicly reporting quality information helps improve performance. Health plans are able to use the results for their own quality improvement. Since the start of reporting in 1994 there have been significant advances in patient care and satisfaction according to CCHRI health plan results. The information collected by CCHRI is used to populate the health plan section of HealthScope, the PBGH online guide to choosing health plans, medical groups and hospitals. It also serves as the primary source of data for the State of California's Office of the Patient Advocate HMO Report Card.

Current Activities: Health plan results of HEDIS and CAHPS data collection projects for the 2002-reporting year appear in the CCHRI Report on Quality. New this year is a section dedicated to the "State of Managed Care in California." The significance of HEDIS performance is discussed in detail with an emphasis on the progress (improved health outcomes, lives saved) attributable to improved HEDIS rates over the years. Also included is a comparison of selected CCHRI all-plan HEDIS averages to national HEDIS averages as reported in NCQA's Quality Compass. Project results provided by CCHRI are displayed on HealthScope and were used to populate the Office of the Patient Advocate HMO Report Card. Click here to download the 2002 Report on Quality and the separate HMO Report Card.

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Adobe Acrobat version 2002 CCHRI Report on Quality.

Adobe Acrobat version of 2002 CCHRI HMO Report Card.

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