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62J.322 PROVIDER INFORMATION PILOT STUDY.
The commissioner shall develop a pilot study to collect comparative data from health
care providers on opportunities and barriers to the provision of quality, cost-effective health
care. The provider information pilot study shall include providers in community integrated
service networks, health maintenance organizations, preferred provider organizations, indemnity
insurance plans, public programs, and other health plan companies. Health plan companies and
group purchasers shall provide to the commissioner providers' names, health plan assignment,
and other appropriate data necessary for the commissioner to conduct the study. The provider
information pilot study shall examine factors that increase and hinder access to the provision of
quality, cost-effective health care. The study may examine:
(1) administrative barriers and facilitators;
(2) time spent obtaining permission for appropriate and necessary treatments;
(3) latitude to order appropriate and necessary tests, pharmaceuticals, and referrals to
specialty providers;
(4) assistance available for decreasing administrative and other routine paperwork activities;
(5) continuing education opportunities provided;
(6) access to readily available information on diagnoses, diseases, outcomes, and new
technologies;
(7) continuous quality improvement activities;
(8) inclusion in administrative decision making;
(9) access to social services and other services that facilitate continuity of care;
(10) economic incentives and disincentives;
(11) peer review procedures; and
(12) the prerogative to address public health needs.
In selecting additional data for collection, the commissioner shall consider the: (i) statistical
validity of the data; (ii) public need for the data; (iii) estimated expense of collecting and reporting
the data; and (iv) usefulness of the data to identify barriers and opportunities to improve quality
care provision within health plan companies.
History: 1995 c 234 art 5 s 9; 1997 c 225 art 2 s 62