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IEHP - Inland Empire Health Plan, A Public Entity


MONITORING QUALITY OF CARE

IEHP Collaborates on National Research Project

IEHP collaborates on national research initiatives to ensure quality health care for people with disabilities. 


Quality Indicators

IEHP’s Chief Medical Officer, Dr. Brad Gilbert, serves on the Advisory Council for a national research project entitled “Medicaid Quality Indicators for Persons with Disabilities.”  Project goals include developing and testing measures of quality, access, and satisfaction of health care services for adults with disabilities. 

New Tools to Monitor Quality

As part of this research initiative, IEHP worked with the National Rehabilitation Hospital’s Center for Health and Disability Research (NRH-CHDR) and the Kaiser Permanente Center on Health Research to develop:

● Innovative software, the Access Risk Classification System (ARCS), to assist health plans in providing additional support to Members with disabilities

● Measures for health plans to conduct outreach, track, and monitor health care services for people with disabilities.

“Despite being at higher risk for health problems, individuals with disabilities are not as likely as the rest of Americans to get preventive care,” explains IEHP CEO Richard Bruno.  “We have 12,000 Members with a disabilities and we’re determined to make sure each one has the opportunity to get the health care they deserve.”

ARCS identifies Members who may need assistance in accessing preventive services by searching health plan records for:

● Medical diagnoses

● Durable medical equipment

● Prescriptions

IEHP served as the test site for ARCS.  Researchers interviewed Members identified by the software to:

● Learn why individuals with disabilities are less likely to receive preventive services

● Design effective action plans to close these gaps

“As more and more individuals with disabilities join our health plan, we want to be able to quickly identify these Members so we can connect them with the services they need to stay healthy,” explains Carl Maier, IEHP Chief Marketing Officer.

 Health Outcomes

IEHP, NRH-CHDR, and Kaiser also developed national health measures regarding services delivered to individuals with disabilities in managed care.  Compatible with the HEDIS® and CAHPS, the measures track and monitor the quality of care. 

HEDIS (Health Plan Employer Data and Information Set), a registered trademark of the National Committee for Quality Assurance, is a set of standardized performance measures related to significant public health issues, customer service, access to care, and claims possessing.

CAHPS (Consumer Assessment of Healthcare Providers and Systems), a registered trademark of the Agency for Healthcare Research and Quality, is a public-private initiative focused on developing standardized surveys of Members’ experiences.

Project Funding

IEHP and a grant from the U.S. Department of Education National Institute on Disability and Rehabilitation Research funded the research initiative.