Evaluation Measures

The measures used to evaluate care coordination programs vary depending on the care coordination model and the goal of the evaluation. Care coordination program evaluations may require numerous measures to assess health outcomes, cost outcomes, and care delivery processes, including quality of care (e.g., coordination, clinical interaction, trust), among other measures.

The AHRQ Care Coordination Measures Atlas maps existing measures to key care coordination activities, and is a useful resource for care coordination evaluation and measurement. Another resource from the National Quality Forum presents endorsed preferred practices in care coordination and corresponding performance measures.

When identifying evaluation measures for care coordination, it is important to consider the three perspectives on care coordination: the patient/family, the healthcare providers, and the healthcare system.

Common measures used by care coordination programs include:

Demographic information on participants and providers

The participant's:

• Age
• Gender
• Type of health insurance
• Socio-economic status
• Ethnicity
• Language spoken

The healthcare provider’s:

• Gross annual operating expenses
• Revenue and revenue per encounter or visit
• Payer mix

Provider’s process measures

• Number of direct/indirect encounters or visits
• Number of duplicated/unduplicated encounters
• Number of care coordinators trained to serve patients using an evidence-based curricula
• Number of healthcare providers offering care coordination services
• Number and level of participation of organizations involved in the program
• Number of referrals to other providers
• Number of people receiving services from a care coordinator
• Number of patients enrolled in a case management program
• Number of case managed patients who have had [number of] visits with their provider [during a particular time period]
• Number of participants who have a self-management plan

Patient outcome measures

• Changes in biometric measures including weight, waist circumference, body mass index, blood glucose levels, etc.
• Changes in ability to self-manage (including activities of daily living)
• Changes in healthy behaviors
• Changes in knowledge
• Changes in transportation costs (e.g., streamlining visits with specialty providers)
• Perceptions
• Health outcomes

For additional information on the types of changes that can be tracked through evaluation, see Evaluation Measures in the Rural Community Health Toolkit.

Resources to Learn More

HEDIS & Performance Measurement
Website
A tool used by health plans to measure performance. The tool consists of 75 measures across 8 domains of care that span important dimensions of care and services.
Organization(s): National Committee for Quality Assurance

Measuring Care Coordination in Medical Homes
Website
This website summarizes seven strategies for measuring care coordination and resources for selecting care coordination metrics.
Organization(s): Commonwealth Fund

Preferred Practices and Performance Measures for Measuring and Reporting Care Coordination
Document
This report presents a set of preferred performance measures related to structure, process, and outcome that can be used for care coordination programs.
Organization(s): National Quality Forum
Date: 10/2010