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Health Care Contracting: Tips for Quality Assurance and Evaluation

May 13, 2021

Five stars are on a table underneath a stethoscope, indicating a five star rating for a doctor or healthcare professional.

Key Takeaways

Most health care organizations will be interested in Community-Integrated Health Network's ability to implement services across a wide geographic area consistently.

A detailed quality assurance and evaluation process will ensure programs are implemented with fidelity, help maintain consistency, monitor progress to make adjustments, and measure the effectiveness of services.

It is vital that quality assurance and evaluation activities be planned and conducted in collaboration with your health care partners. Sharing responsibilities between you and your health care partners is important. You should build quality assurance (QA) and evaluation agreements into the contract, outlining how responsibilities will be shared and who is responsible for what. Costs for carrying out QA and evaluation need to be taken into consideration and can be included in the unit rate cost for each participant.

As part of these efforts, different types of program and individual-level data can be collected. Metrics may include workshop attendance, participant demographic information, participant activation, participant satisfaction, self-reported outcomes, and/or clinical indicators, such as Hemoglobin A1C levels.

During early conversations with health care partners

Considerations for your QA plan as your partner with health care organizations

No matter what data is collected and reported on, it is important to develop a clearly defined process and metrics that are mutually agreeable to the Network, community-based partners, and health care partners. Once decisions are made, all partners should continue to be involved in discussions and actively engaged in assessing progress and program outcomes.

Helpful resources