Utilization Management: Quality Indicators
Tracking # 20-921218
Course overview
Quality indicators measure quality and utilization to identify problems, areas that warrant further investigation, and changes over time (Agency for Healthcare Research and Quality [AHRQ], 2021). Numerous agencies dedicated to healthcare improvement in the U.S. have developed parameters to create meaningful change in how care is provided. Hospitals can choose which parameters they would like to implement and some agencies provide resources for how to collect, transmit, and analyze data. For example, The Joint Commission (TJC) and Centers for Medicare and Medicaid Services (CMS) developed measures and provides technical specifications for how the electronic medical record (EMR), billing, coding, and other structured, encoded data can be used to monitor their chosen parameters (TJC, n.d.-a; QualityNet, n.d.-c). A plethora of hospital performance markers provide an objective assessment of the quality, cost, and efficiency of healthcare.
Subject areas
This course counts toward the state boards and subject areas below.