BUS FPX 4123 Assessment 6 Evaluating Current Quality Assurance Efforts

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Capella University

BUS-FPX4123 Quality Assurance and Risk Management

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National Committee on Quality Assurance and HEDIS

The National Committee on Quality Assurance (NCQA) is a nonprofit organization established in 1990 to enhance the quality of healthcare through standardized performance measures (NCQA, 2021). One of its primary tools, the Healthcare Effectiveness Data and Information Set (HEDIS), is used to evaluate and ensure accountability in healthcare organizations and plans. NCQA’s mission focuses on improving healthcare quality by identifying gaps and implementing corrective measures through HEDIS. This set of measures evaluates healthcare performance across six domains, aiding organizations in making impactful improvements in patient outcomes.

The HEDIS Roadmap is a key component of this system. It compiles data on an organization’s information management practices that influence HEDIS reporting. While the Roadmap does not assess the efficiency of information systems, it is a mandatory annual requirement for NCQA HEDIS audits. This document provides auditors with the foundational information needed to complete their evaluation effectively. Consequently, organizations must respond to Roadmap inquiries with precision and detail to ensure a seamless audit process.

HEDIS Measures for Cervical Cancer Screenings (CCS)

Cervical Cancer Screenings (CCS) fall under the “effectiveness of care” domain within HEDIS measures. According to the American Cancer Society (2021), approximately 14,480 new cases of cervical cancer and 4,290 related deaths were estimated in 2021. These screenings have played a significant role in reducing cervical cancer rates and deaths since their inclusion in HEDIS measures in 1999. Revisions to these measures in 2013 aligned them with the U.S. Preventive Services Task Force (USPSTF) guidelines, further strengthening their impact (NCQA, 2020).

The primary method of CCS involves Pap tests, which detect precancerous or abnormal cells, thereby facilitating early intervention. For women aged 21 to 29, USPSTF recommends cytology screening every three years. For women aged 30 to 65, combined cytology and high-risk human papillomavirus (hrHPV) screenings every five years are recommended (USPSTF, 2018). These guidelines have significantly reduced mortality associated with invasive cervical cancers.

Benefits of Quality Programs

Quality improvement programs like HEDIS provide significant advantages for patients, healthcare organizations, and communities. Implementing HEDIS measures has contributed to reducing cervical cancer mortality by enabling early detection and treatment. For patients, early diagnosis minimizes the need for invasive and expensive treatments. For example, treating precancerous lesions is less costly and less invasive than addressing invasive cervical cancers. Furthermore, regular screenings decrease the likelihood of cancer recurrence, reducing long-term healthcare costs (CDC, 2021).

Healthcare organizations benefit by closing care gaps, improving patient outcomes, and enhancing their reputation. When organizations adhere to these measures, they demonstrate their commitment to quality care, thereby boosting patient trust and organizational credibility.

BUS FPX 4123 Assessment 6 Evaluating Current Quality Assurance Efforts

Table Representation

Aspect	Description	Benefits
NCQA & HEDIS	NCQA ensures healthcare quality using HEDIS, which evaluates organizational performance.	Improves care quality by addressing gaps and holding organizations accountable.
HEDIS Cervical Cancer Measures	Focuses on early detection through regular screenings aligned with USPSTF guidelines.	Reduces cervical cancer incidence and mortality through early intervention.
Quality Program Benefits	Quality programs enhance outcomes for patients and organizations.	Reduces healthcare costs, improves reputation, and minimizes the need for invasive treatments.

References

American Cancer Society. (2021, January 12). Cervical Cancer Statistics | Key Facts About Cervical Cancer. https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html

CDC. (2021, August 18). Cost-Effectiveness of Cervical Cancer Interventions | Power of Prevention. National Center for Chronic Disease Prevention and Health Promotion. https://www.cdc.gov/chronicdisease/programs-impact/pop/cervical-cancer.htm

National Committee for Quality Assurance (NCQA). (2021, September 16). About NCQA. https://www.ncqa.org/about-ncqa/