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Measuring Plans and Measuring Health
- David R. Nerenz, PhD
- Henry Ford Health System; Detroit, MI 48202 Note: This article is one of a series of articles comprising an Annals of Internal Medicine supplement entitled “Measuring Quality, Outcomes, and Cost of Care Using Large Databases: The Sixth Regenstrief Conference.” To see a complete list of the articles included in this supplement, please view its Table of Contents.
Nearly 10 years ago, Ellwood challenged us to become part of the “third revolution” [1] in health care: an approach he called “outcomes management” [2]. Outcomes management involves a commitment to measuring health status outcomes, to pooling information among providers to facilitate learning about what works, and accountability.
The challenge has not yet been met. We do measure things but generally not outcomes. We combine and share information, but this information is generally about processes, algorithms, and “best practices” and not necessarily about outcomes. We are accountable to purchasers, communities, and individual patients but often in terms of costs, access, and satisfaction rather than clinical outcomes. The four articles in this section offer clues to the reasons Ellwood's vision of outcomes management has not yet become reality.
Spoeri and Ullman describe one particular area of performance measure effort-the 1994 HEDIS (Health Plan Employer Data and Information Set) pilot project. Many readers are likely familiar with HEDIS' basic content and utility. The issues about provider profiling and inclusion of outcome data raised in the second half of the Spoeri and …
