Using federal standards set by the National Committee for Quality Standards, the site gives consumers access to data on the quality of healthcare treatment and prevention, disease management, and behavioral health for advanced network providers and federally-qualified health centers operating throughout Connecticut.
Advanced networks are provider systems that are accountable for their entire patient population. They are designed to improve the quality of care and contain costs by operating as a system that manages the whole patient.
Supported by a four-year $45 million State Innovation Model (SIM) grant awarded in 2014 by the Center for Medicare and Medicaid Innovation, interactive tables and graphs to allow consumers to search, sort, and filter by entity, quality measure, health topic, and rating.
Our 5-star rating system is based on whether the organization falls below, meets, or exceeds the state’s average. By taking the distribution of scores for all of the organizations, we rate each based on the standard deviation. Standard deviation helps to show how far someone is from the average. A 3-star rating implies they match or are extremely close to the state average. Likewise, 4 and 5-star ratings imply that the organization has exceeded the state average.
Attribution is the assignment of a patient to a primary care provider (PCP) who provides most of the patient’s care.
The Connecticut Office of Health Strategy has adopted the TREO/3M attribution model, which is extensively used in the healthcare industry.
This approach is based on the majority of evaluation and management services a patient receives from a primary care physician. It is a two-step process that attributes patients to providers and providers to medical groups.
TREO also allows for customization in the providers to whom patients can be attributed and in the time period used to determine attribution.
Healthscore CT Scorecard Attribution Logic
The Healthscore CT scorecard attribution model uses the available data in the All-Payer Claims Database to rate the performance of healthcare organizations to whom patients are attributed. It is important to note that this attribution is not intended for payment purposes. The attribution model has been developed in collaboration with the SIM Quality Council, an advisory body made up of consumer health advocates, providers, community organizations, and payers.
Attributing patients to providers
The intent of the attribution logic is to determine the healthcare organization that is responsible for a patient’s primary care. The Healthscore CT scorecard attribution model first attributes a patient to a PCP with whom the patient has had the most visits during the measurement year.
PCPs are attributed to a healthcare organization using billing National Provider Identifier or site of care. An initial list of National Provider Identifiers is produced and then shared with the rated entities. Rated entities may request revisions to this list.
The attribution model uses the following definitions:
Evaluation & Management Visits: E&M visits are defined as outpatient visits with CPT codes of 99201-99499.
Primary Care Provider (PCP): Physicians, Advanced Practice Registered Nurse (APRN), or Physician Assistants (PA) with the specialty of Family Medicine, Internal Medicine, Pediatrics, or General Practice. Note: attribution to APRNs and PAs as allowed by data.
Measurement Year: The 12 month period beginning on 10/1 and ending 9/30 during which healthcare organization performance is being rated.
The Cost Estimator
The cost estimator tool lets you see the low, median, and high costs when you search for a particular procedure or by provider. Healthscore CT obtains health insurance claims data through the All-Payer Claims Database (APCD) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys.
(All APCD data is presented to users as unidentified and is stored on a secure HIPAA-compliant, encrypted server and conforms with national standards for security, including HITRUST certification.)