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.

Use Case Summary, Implementation Guide and Supporting Documents


QMI Implementation Guide

APS File Specification

Gaps in Care File Specification

 

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.

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