Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Date of Award

Fall 2017

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

Department

School of Nursing

Advisor(s)

Sharon Zook

Andrea Knopp

Len Scarpinato

Abstract

Healthcare Effectiveness Data and Information Set (HEDIS) is a quality measurement for standard of care used to rate a health plan or provider's ability to demonstrate clinical effectiveness. Medicare Advantage healthcare plan utilizes HEDIS as a guide for standard of care. Adherence to HEDIS is useful in decreasing chronic disease burden through preventative measures. Diabetes, a disease with high burden, has Comprehensive Diabetes Care HEDIS standards that specifically target providers. Increasing adherence to HEDIS measures is shown to significantly improve health outcomes when used with evidence-based guidelines. The literature shows having high HEDIS scores are not an incentive to adhere to the measures for providers. Furthermore, financial incentives are often not enough of a motivating factor. This project assessed current attitudes, beliefs, and behaviors of primary care providers that service Medicare Advantage patients, implemented a Practice Improvement Module (PIM) intervention and evaluated its effectiveness. With the PIM, there was positive movement in categories relating to relevance, awareness and understanding, behavior control, and impact related to use of HEDIS.

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