NCQA Presents New Research at AcademyHealth ARM

July 24, 2024 · Becky Kolinski

The AcademyHealth Annual Research Meeting (ARM), which was held in July, is a leading venue for health services researchers and health care policy experts to come together to discuss new research findings and policy implications. NCQA attended this year’s meeting to share insights from our latest health care research.

“Presenting at the AcademyHealth Annual Research Meeting is an opportunity to engage and learn from a broad range of perspectives, including the latest research on many topics directly connected to NCQA’s strategy and mission,” said Rachel Harrington, AVP, Health Equity Sciences. “We’re stronger for our ability to bring these insights into our work.”

NCQA presented on three topics:

• Early Lessons in Integrating SDOH Measurement Into Practice.
• Disparities in Access to Well-Child Visits Among Commercial Health Plans.
• National Variation in Outpatient Surgery Quality Across Medicare Advantage Plans.

This article shares a summary of our findings.

Data Fragmentation Is a Barrier to Collecting and Reporting SDOH Data

NCQA researchers interviewed eight health plans about their experience collecting and reporting data elements for two new HEDIS measures, Social Need Screening and Intervention (SNS-E) and Social Connection Screening and Intervention (SCS-E). These measures were developed to capture health plans’ performance in addressing their members’ social needs.

Key Findings

• Barriers in coding practices, data storage, extraction and mapping impede collection and reporting of SDOH data.
• SDOH data live in multiple data systems that don’t “talk to” each other, resulting in fragmented data collection.
• SDOH data are manually mapped from multiple systems—a time-consuming, resource-intensive process.
• Data fragmentation makes it difficult to link a positive screen to a corresponding intervention within a specific time frame.
• Screening tools should be standardized to facilitate easy adoption at the health plan and clinician level.

“The research and implementation of social needs screening within the health care sector is rapidly evolving,” said Adrianna Nava, NCQA Applied Research Scientist. “By sharing our insights with health services researchers and professionals, we work to bridge the gap between theory and practice.”

NCQA Contributors

Adrianna Nava, PhD, MPA, MSN, RN
Kristen Bishop
Polina Lissin, MPH

View Early Lessons in Integrating SDOH Measurement Into Practice here.

NCQA Found Ethnicity Disparities in Access to Well-Child Visits

In 2022, NCQA required health plans to stratify the HEDIS Child and Adolescent Well Care Visits (WCV) measure by race and ethnicity for the first time. This provided insight into race and ethnicity data completeness—and performance disparities—for commercial health plans.

WCV looks at children 3–21 years of age who had at least one comprehensive well-care visit during the measurement year.

Key Findings

• The average overall performance rate for well-child visits was 57.0%.
• Performance was highest among the Asian population (64.3%) and lowest among the Native Hawaiian or Other Pacific Islander population (52.7%).
• There was wide variation in plan performance within each racial and ethnic group, suggesting that there is room for achievable quality improvement.
• Ethnicity data were found to be less complete than race data, indicating that health plans should reevaluate how they ask members about race and ethnicity.

“By presenting at ARM, we can share knowledge and build a network relevant to our work,” said Keirsha Thompson, Assistant Director, Health Equity Sciences. “We also get to connect with colleagues who are working on topics that are unrelated to our research. I think this is just as important because it can open our eyes to future research opportunities.”

NCQA Contributors

Keirsha Thompson, MSW
Rhea Mundra, MPH
Shawn Trivette, PhD
Rachel Harrington, PhD

View Disparities in Access to Well-Child Visits Among Commercial Health Plans here.

Males and Older Adults Have Higher Rates of Hospitalization After Surgery

More than 70% of surgeries are performed in outpatient settings, prompting increased attention to safety and quality. NCQA researchers compared the rates of acute, unplanned hospitalizations (inpatient and observation stays) within 15 days after an outpatient surgery for Medicare Advantage patients. The study focused on four outpatient procedures: colonoscopy, general surgery, orthopedic and urology.

Key Findings

• 15-day hospitalizations were highest among males and people 85 years of age and older.
• Diabetes, heart arrhythmia and vascular disease were the most common co-morbid conditions among hospitalized patients.
• Health plans can help improve patient outcomes by contracting with high-quality facilities and ensuring appropriate follow-up and care coordination.

“By sharing our research, we can signal to the health care policy community that we are planning to measure outpatient surgery outcomes more rigorously,” said Ezra Fishman, Lead Data Scientist. “We can also get feedback from experts about how to make our measure and its associated risk-adjustment models better.”

NCQA Contributors

Danielle Rainis, MPH
Rhea Mundra, MPH
Ezra Fishman, PhD
Rachel Harrington, PhD

View National Variation in Outpatient Surgery Quality Across Medicare Advantage Plans here.

NCQA’s Commitment to Health Care Research

NCQA is proud of the contributions made by our researchers toward improving the quality of health care delivery in the United States. Our work can inform decisions by researchers and policymakers across the country who attend the AcademyHealth ARM to learn the same way we do.