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Health Care Contracting: Tips for Quality Assurance and Evaluation

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

  • Discuss QA and evaluation as a necessary element of successful collaboration for program delivery
  • Emphasize that QA is an ongoing process, which is more likely to be successful when the health care partner plays a role
  • Review the QA measures that are in place and explain their importance in monitoring and achieving the desired program results
  • Outline the QA and evaluation process in written agreements, including agreed-upon outcome measures that will be tracked and monitored
  • Discuss how QA and evaluation will be a regular part of program review in ongoing partner meetings

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

  • Determine together what data you will collect, how you will collect it, and how you will manage it on an ongoing basis
  • Develop a listserv and other ways to share information across the state
  • Develop coordinated data collection and data entry procedures that include monitoring the data for fidelity
  • Develop fidelity monitoring processes and provide training for staff, volunteers, and partners so that everyone understands what is expected
  • Share fidelity tips in newsletters and other communications
  • Provide regular trainings, conferences, and refresher trainings around evidence‐based programs

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

 

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Community-integrated health care is more important than ever as older adults elect to age in place and community-based organizations deliver essential services. Explore resources for pursuing complex sustainability strategies and creating stronger linkages with the health care sector.

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