September 7, 2009

Promising Practices in Home & Community-Based Services: Combining Data From Claims & Services

This brief by the federal Centers for Medicare and Medicaid Services reviews a health information technology system 'Service Process Quality Management(SPQM)' that can help control costs and improve the quality of the services delivered. The experiences of organizations that have implemented SPQM suggest the benefits of a system that combines claims-level data with service-level data. For example, organizations can reduce their no-show rates, encourage the use of cost-effective services, and compare the array of service that Medicaid consumers receive with the array of service that non-Medicaid consumers receive.