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Program objective

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Improve the quality of care through better measurement.

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The challenge

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Measuring the quality of care is vital to improving health care. Measures can identify gaps in care and establish targets for success. But defining the best standards for measurement is challenging and requires system-wide consensus on what measures truly matter. 

To help improve quality, OptumLabs® engages in projects with multiple partners aimed at developing and/or testing novel quality measures with our data. We believe quality measurement can meaningfully improve patient experiences in the transition to value-based care.

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Measures program pillars: Create new measures to fill key gaps, develop
methods to improve measurement and identify high-value measures.   

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Our role

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OptumLabs is driving innovation in measures dedicated to improving health care quality. Current focus areas include: home-based medical care, diabetes, serious illness, anticoagulant safety and adverse event triggers in cancer.

We convene diverse project teams and stakeholders, design and test concepts, and apply advanced data science techniques to complex data to uncover new ways to improve health. Measure development is supported by funding from AARP Quality Measure Innovation Grants.

We are also a national CMS Qualified Entity, which gives us access to Medicare fee-for-service (FFS) data.

By combining this government insurance data with our existing rich, longitudinal data from commercial insurance, electronic health records (EHR) and other data sources, we discover new insights about the quality of care in the U.S.

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Quality Entity Certified logo

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Our quality reports examine two major themes. The first evaluates how process of care measures relate to key health outcomes. The second examines care at the critical time when individuals transition from commercial insurance to Medicare coverage (either FFS or Medicare Advantage). 

The result? We are helping to create measures that matter — not just to scientists and researchers, but to everyone involved in health care.

View reports

Understanding complex health care data is crucial to extracting insights. We know how to ask the right questions and interpret the signals.

– Darshak Sanghavi, MD, Chief Medical Officer and SVP Translation, OptumLabs
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Collaborators

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Quality measure development/testing

  • AARP 
  • American Academy of Hospice and Palliative Medicine
  • AMGA 
  • Johns Hopkins Bloomberg School of Public Health
  • Mayo Clinic
  • National Committee for Quality Assurance (NCQA)
  • Pharmacy Quality Alliance
  • Physician Consortium for Performance Improvement (PCPI) Foundation
  • Tufts Medical Center
  • University of California, San Francisco
  • University of Maryland, Baltimore 
  • Yale Center for Observational Research Evaluation