CEBS GBA EXAM 1
What are aims of health system performance evaluations? (Mod 12.3)
- ANSWERS-Aims vary: some are to provide health system managers
with data to help improve performance, provide purchasers with
assessments about how health system is performing, some are to
provide patients or consumers with info that can be useful if they are
free to choose between 2 or more systems
Define and explain 3 types of health system performance evaluations
(Mod 12.3) - ANSWERS-Audit Performance Evaluations (APE):
-compares health system with a statement of what is expected; if ER
wants to offer health benefits, they could contract with a health
system; ER wants to know whether health system provides the
services needed, so might use evaluator to specify; another example is
National Committee for Quality Assurance (NCQA) accreditation of
ACO - accountable care organization which is a network of doctors
and hospitals that assume financial responsibility managing the health
care of a specific group of patients - if able to provide lower costs,
they receive financial awards. NCQA provides accreditation to all
ACOs, which is ex of APE
Single-case time trend performance eval:
-track performance of health system over time; use routinely collected
and reported data and compare at different times
Service-comparison performance evaluation:
,-compare performance of a set of services at one time, in relation to
one or more dimensions of service performance; most developed and
longest running systems report quality and safety data but not costs,
so value assessment not possible.
Detail steps in conducting a return on investment (ROI) evaluation
(Mod 12.4) - ANSWERS-Evaluation is planned and prospective,
makes it possible to identify data needed beforehand and set up
systems to gather/extract data
-Define the change that investments will be used to make
-List the time and other resources needed to make the change and
sustain the change once it is made.
-Define the investment and the investor.
-Define the returns to be valued.
-Decide the ROI study design and data (involves defining methods to
assess whether returns were due to investment change or some other
influence; then it involves deciding which data to gather from which
source
-Collect and analyze data and present investment costs and time
period of investment, returns at year one from start and years 2 and 3,
as well as ROI at 3 years.
-Specify assumptions, limits, and a degree of certainty in the
evaluation.
Is an ROI evaluation the same as a business case assessment? (Mod
12.4) - ANSWERS-Part of many business assessments; a business
case is where the justification, plan and expected results are laid out in
one document; this might include
,-current problems/opportunies
-how and why a change will help solve issues
-time, money and other resources
-expected benefits and ROI at 1, 3 and 5 yrs
-risk and risk management strategies
-expected situation if change is not made
-outline draft plan of next steps
How are value improvements evaluated and predicted? (Mod 12.4) -
ANSWERS-Evaluated:
-value improvements are changes that both improve quality, reduce
waste and usually reduce costs of producing a service; evaluations are
needed to assess whether promised changes do improve quality and
reduce waste, as whether cost is worth improved quality.
-one type of eval is a cost quality ROI (CQROI); this is broader than a
typical ROI since it considers both the quality and resource returns.
ROI usually only consider payback for the investor - money they get
back by certain date
Predicted:
-assessing previous research to determine if change will be a value
improvement.
-Process:
--> For studies with evidence of problems, select those that quantify
problems and use these to estimate possible waste or costs
, -->For interventions studies, exclude those with inadequate evidence
of quality improvements
--> identify studies with acceptable evidence of quality improvement
and some evidence of resources or cost
--> for studies with evidence of quality improvements only, identify
whether they provide data to allow some estimate of resources used in
intervention
How is value improvement estimated by local service providers?
(Mod 12.4) - ANSWERS--Does previous research or info give strong
evidence of quality improvement? If yes, than continue:
-How much does intervention cost?
-Is there any evidence of reductions in waste and more efficient use of
resources?
-What is money value of reductions?
-If no evidence of research on prior 2 points, then use theory or
estimations for cost range
-Overall what is ROI?
-Time to pay off: how are spending and savings distributed between
different parties at years 1, 2, 3, 5 and 10...etc
What constitutes a good ROI evaluation? (Mod 12.4) - ANSWERS--
Specifies user(s) of the evaluation and decisions the evaluation will
inform
-Identifies all costs and benefits that are important to users decisions
and measures in financial terms those that are feasible to measure
What are aims of health system performance evaluations? (Mod 12.3)
- ANSWERS-Aims vary: some are to provide health system managers
with data to help improve performance, provide purchasers with
assessments about how health system is performing, some are to
provide patients or consumers with info that can be useful if they are
free to choose between 2 or more systems
Define and explain 3 types of health system performance evaluations
(Mod 12.3) - ANSWERS-Audit Performance Evaluations (APE):
-compares health system with a statement of what is expected; if ER
wants to offer health benefits, they could contract with a health
system; ER wants to know whether health system provides the
services needed, so might use evaluator to specify; another example is
National Committee for Quality Assurance (NCQA) accreditation of
ACO - accountable care organization which is a network of doctors
and hospitals that assume financial responsibility managing the health
care of a specific group of patients - if able to provide lower costs,
they receive financial awards. NCQA provides accreditation to all
ACOs, which is ex of APE
Single-case time trend performance eval:
-track performance of health system over time; use routinely collected
and reported data and compare at different times
Service-comparison performance evaluation:
,-compare performance of a set of services at one time, in relation to
one or more dimensions of service performance; most developed and
longest running systems report quality and safety data but not costs,
so value assessment not possible.
Detail steps in conducting a return on investment (ROI) evaluation
(Mod 12.4) - ANSWERS-Evaluation is planned and prospective,
makes it possible to identify data needed beforehand and set up
systems to gather/extract data
-Define the change that investments will be used to make
-List the time and other resources needed to make the change and
sustain the change once it is made.
-Define the investment and the investor.
-Define the returns to be valued.
-Decide the ROI study design and data (involves defining methods to
assess whether returns were due to investment change or some other
influence; then it involves deciding which data to gather from which
source
-Collect and analyze data and present investment costs and time
period of investment, returns at year one from start and years 2 and 3,
as well as ROI at 3 years.
-Specify assumptions, limits, and a degree of certainty in the
evaluation.
Is an ROI evaluation the same as a business case assessment? (Mod
12.4) - ANSWERS-Part of many business assessments; a business
case is where the justification, plan and expected results are laid out in
one document; this might include
,-current problems/opportunies
-how and why a change will help solve issues
-time, money and other resources
-expected benefits and ROI at 1, 3 and 5 yrs
-risk and risk management strategies
-expected situation if change is not made
-outline draft plan of next steps
How are value improvements evaluated and predicted? (Mod 12.4) -
ANSWERS-Evaluated:
-value improvements are changes that both improve quality, reduce
waste and usually reduce costs of producing a service; evaluations are
needed to assess whether promised changes do improve quality and
reduce waste, as whether cost is worth improved quality.
-one type of eval is a cost quality ROI (CQROI); this is broader than a
typical ROI since it considers both the quality and resource returns.
ROI usually only consider payback for the investor - money they get
back by certain date
Predicted:
-assessing previous research to determine if change will be a value
improvement.
-Process:
--> For studies with evidence of problems, select those that quantify
problems and use these to estimate possible waste or costs
, -->For interventions studies, exclude those with inadequate evidence
of quality improvements
--> identify studies with acceptable evidence of quality improvement
and some evidence of resources or cost
--> for studies with evidence of quality improvements only, identify
whether they provide data to allow some estimate of resources used in
intervention
How is value improvement estimated by local service providers?
(Mod 12.4) - ANSWERS--Does previous research or info give strong
evidence of quality improvement? If yes, than continue:
-How much does intervention cost?
-Is there any evidence of reductions in waste and more efficient use of
resources?
-What is money value of reductions?
-If no evidence of research on prior 2 points, then use theory or
estimations for cost range
-Overall what is ROI?
-Time to pay off: how are spending and savings distributed between
different parties at years 1, 2, 3, 5 and 10...etc
What constitutes a good ROI evaluation? (Mod 12.4) - ANSWERS--
Specifies user(s) of the evaluation and decisions the evaluation will
inform
-Identifies all costs and benefits that are important to users decisions
and measures in financial terms those that are feasible to measure
