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Show Primary Care and Rural Health Systems, and Community Health Nursing); the Offices of Public Health Data and Health Data Analysis; and the Health Policy Commission support staff. The Division of Health Care Financing is the Medicaid agency for the state of Utah. The development and distribution of regulatory compliance report cards is being undertaken by two bureaus in the Division of Health Systems Improvement. Efforts are also underway to evaluate the usefulness of these report cards. It is readily acknowledged by the developers that these are "first attempts," needing to be consistently evaluated and improved. The responses to the surveys sent to the consumers of these report cards were generally positive with the majority of the respondents rinding the report cards valuable. There is a need to do more education about their availability, however, and action will be taken on that input. The report cards currently available and their source are listed below: •NURSING HOMES-record of annual inspection compliance from 1991-1994 of all licensed/certified nursing homes in Utah. Individual survey reports are available, and a comparison report per number of deficiencies, and severity of deficiencies is included, as well as information on general trends in compliance. This is put out by the Bureau of Program Certification and Resident Assessment (BPCRA). It is in libraries throughout the state and can be accessed by contacting the local Area Agency on Aging, the local or state long-term care ombudsman program, or BPCRA (801-538-6157). •RESIDENTIAL HEALTH CARE FACILITIES-contains similar information to the nursing home report card, with survey compliance reports from 1993 and 1994. Prepared by the Bureau of Health Facility Licensure (BHFL), it too is available in libraries, and from local Area Agencies on Aging, the ombudsman program, and the BHFL (801-538-6152). •INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED-issued by the Bureau of Program Certification and Resident Assessment (BPCRA), 801-538-6157. This report contains survey compliance information as above. All contain explanations as to how surveys are conducted, and what is evaluated during the survey process. Suggestions for questions to ask when choosing a facility are included. The next regulatory compliance report cards to be issued will relate to home health agencies (fall, 1995) and hospitals (1996). in the near future, similar reports for psychiatric hospitals, hospices, and other licensed entities in Utah will be released. Each year, a customer satisfaction survey will be conducted to determine the value of and customer satisfaction with these reports, and improvements will be made as concerns are noted. The customer surveys conducted this year have shown the reports to be considered helpful by nursing home and residential health care facility consumers. These report cards are one tool for a consumer to use when choosing a facility. They are also used by payers and health plans wishing to contract with such facilities, and nursing home and residential health care providers can use them to benchmark against each other's performance. Future Efforts The Health Systems Reform Team is working closely with the Quality Technical Advisory Group (Q-TAG) of the Health Policy Commission to develop a report card for health plans doing business in Utah. A subcommittee of the Q-TAG is currently studying this challenge, and has made recommendations to the Health Policy Commission in July and August of 1995. Inquiries can be directed to the Health Policy Commission staff at 801-538-6970. The Q-TAG has recommended the Healthplan Employer Data and Information System (HEDIS) as a starting point for statewide health plan performance reporting. Additionally, Medicaid is requiring HEDIS reporting by managed care organizations who enroll Medicaid clients. The Utah Health Data Committee is evaluating options for expanding statewide reporting beyond its hospital discharge data reporting system currently in place. The current HEDIS measures provide a logical starting point for health plan performance measurement. There is broad acceptance by the industry, methods for data collection have been defined, and many health plans are investing in information systems capable of capturing and reporting HEDIS data. The HEDIS measures were designed by the managed care industry in cooperation with purchasers who are increasingly demanding accountability and value. Collection of measures which are clinically relevant or reflect a systematic or community view of health care have yet to adequately evolve and will require efforts to achieve community-wide consensus on those measures. Several factors challenge the development and implementation of regulations for reporting health plan data are: 14 Report Cards |