Quality in Accountable Primary Care Clinics: Should we risk adjust for type of health care insurance? - A talk by Douglas Wholey October 12, 2010

Primary care clinics are increasingly being held accountable for the quality of care they deliver. Minnesota Community Measurement's public reporting of clinic quality is one example of this trend. Typically these measures adjust for a patient's health condition in some form. However, these measures are usually not adjusted for type of health insurance coverage, such as commercial insurance, Medicare, Medicaid, or self-pay/uninsured. This presentation describes methods for adjusting clinic quality measures for diabetes and vascular care, and examines whether it would be appropriate to implement risk adjustment for health insurance coverage. This work was conducted with the support of Minnesota Community Measurement.

Douglas Wholey, PhD is a professor of organizations and management at at the University of Minnesota School of Public Health, Division of Health Policy and Management. His research focuses on professional teams, particularly trans-professional teams such as health care homes that provide services for disadvantaged individuals or individuals with chronic conditions and primary care organization. He has studied the social structure of markets, managed care markets and organizations, public health systems, social service and health networks, information systems, and software teams. His teaching focuses on management, particularly lean management, problem solving, and social networks, and information management. His research and teaching overlap in a course he teaches on Managing Electronic Health Information where he covers claims data management, quality measurement, resource use measurement, risk adjustment, and reliability. Dr. Wholey holds M.B.A. and Ph.D. degrees from the Haas School of Business at the University of California, Berkeley. His Ph.D. is in organizational behavior and industrial relations.

Official Website: http://www.ias.umn.edu/collabs10-11/CareTeams.php