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Show Utah's 1996 Survey of Enrollees in Medicaid-Contracted HMOs Development and Implementation by Luis Paita The 1996 Utah Survey of Enrollees in Medicaid-Contracted HMOs is part of Utah's health care performance measurement ("report cards") project. Report cards - publicly disseminated measures of performance by health plans and providers of health care - are designed to create competition based on quality of care. In theory, publication of performance measures will stimulate market forces which will in turn create incentives for improvement in quality of health care. If successful, report cards will help promote universal accountability. Health care providers would be accountable for the clinical quality of the care they provide; health plans, access to and the cost of obtaining high quality of care; employers, choice of employee benefit packages; and, individuals, rational decisions regarding health plans, providers, and their own lifestyle. The report card effort in Utah gained legislative support in May of 1995, when the Quality Technical Advisory Group (QTAG) provided recommendations to the Health Policy Commission concerning the type, direction and degree of efforts that the State should be supporting to assess the quality of health care delivered in Utah. The QTAG believed that better information made publicly accessible would help the citizens of Utah to make more informed health care choices, and the State to help monitor the impact of health care providers and systems on the health of the population. The recommendations from the QTAG provided the impetus for the performance measurement project. Through Senate Bill 171, the state legislature clarified that the Utah Health Data Committee, created in 1990 through the Utah Health Data Authority Act (Utah Code 26-33a), has the authority to produce comparative performance reports. The Committee is composed of thirteen individuals appointed by the governor representing health care stakeholders: small businesses, big businesses (2 seats), nurses, consumers (3 seats), hospitals, third party administration, health maintenance organizations, physicians, and public health (2 seats, added through 1995 amendment). The composition of the Committee, the involvement of community advisory committees, and the private partnerships it has created over the years, assure that the processes it follows in creating its data products are based on a consensus resulting from a consideration of different perspectives on a particular issue. Over a period of four months, a planning subcommittee created by the Health Data Committee met every two weeks and developed a prioritized set of strategies for performance measurement and reporting to be implemented over a period of three years. The plans are described in the document: "Utah Health Care Performance Measurement Plan" which the Committee has made publicly available in June of 1996. The first component of the performance measurement project is the measurement of consumer satisfaction with their health plan. This component is being implemented incrementally according to type and number of health plans included. The first two phases were completed in 1996. The first phase is a statewide survey of a random sample of insured individuals in the state as part of Utah's 1996 Health Status Survey. The second phase is a survey of enrollees in Medicaid-contracted HMOs. The third phase, already in its planning stage, will be a survey of enrollees in all twelve HMO plans in the state to be conducted in mid-1997. The first phase is described briefly below. Phase I, statewide survey of insured individuals, was included as an eight-item supplemental module in the 1996 Utah Health Status Survey (HSS). More than 1,800 insured individuals were asked about aspects of their health plan. The 1996 HSS is the third in a series of statewide surveys conducted every five years to provide trend data on the health of Utah's population, including health insurance coverage, health care access, various measures of health status, health care utilization, and preventive behavior. The planning and management of the survey was the responsibility of the Office of Public Health Data, Utah Department of Health. The implementation of 14 Utah's 1996 Survey of Enrollees |