Quality Measure Information (QMI)
The Quality Measure Information (QMI) use case enables providers and payers to consolidate and standardize the electronic exchange of quality-related data to enable quality measurement and support quality improvement to close gaps in care.
About this Use Case
Enabling providers to consolidate supplemental clinical quality information into a single feed routed through MiHIN using the same standardized reporting format, which MiHIN evaluates, validates and distributes to the health plans/payers based on those payers’ membership information.
All inbound and outbound quality information to/from payers are in a single, statewide standardized format.
This use case also supports quality measure performance feedback to providers from an all-payer/all-patient perspective by capturing standardized gaps-in-care reports produced by payers. MiHIN aggregates and then routes the gaps-in-care information back to all providers who have a relationship with that patient. Standardizing and streamlining the gaps-in-care process, reporting formats, and information transport results in more closed gaps-in-care, improved HEDIS scores for health plans, and better care for patients.
QMI Use Case participation in The Physician-Payer Quality Collaborative includes two different activities:
◼ Supplemental Data Filtering: MiHIN receives all-payer supplemental data files in single standard format from participating organizations. MiHIN then separates this information into payer-specific files based on the payer’s attributions and routes that data to the appropriate payer, in a single standard format.
◼ Report Gaps-in-Care: Once supplemental data is combined with claims data and processed by payers, the raw results data is sent back to MiHIN, in a standard format. MiHIN aggregates the raw data and and distributed back to providers in one consolidated gaps-in-care report.