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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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Overview

Data monitoring, from the highest level down to the patient level is critical to identifying trends, gaining insights, and communicating transparently with staff and stakeholders. Data monitoring approaches such as dashboarding are used to display data in a simple and intuitive way, allowing a snapshot of performance on selected measures to see changes or areas for improvement. Business intelligence systems such as population health management analytics allows for the monitoring of the health of a whole patient population, stratified by various characteristics, thereby supporting care planning, resource allocation, and training opportunities. Resources in this section include tools to begin dashboarding, considerations for taking the next step with population health management and guidance on how to navigate the many factors of any data monitoring approach.

Monitoring and Communicating with Data
Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and Other HIV Prevention Strategies: Billing and Coding Guide
HITEQ Center
/ Categories: Priority Topics, Ending the HIV Epidemic, HIV, PrEP

Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and Other HIV Prevention Strategies: Billing and Coding Guide

Developed by NASTAD, updated in 2023

Health departments and other medical providers are billing Medicaid, Medicare, and private insurers for services related to HIV prevention. The counseling services needed for the treatment and discussion of lab tests are intensive. This guide describes the procedure and diagnosis codes that are accepted by public and private insurance, along with specific requirements for some Current Procedural Terminology (CPT®) billing codes. It also describes some of the challenges in obtaining reimbursement for testing, counseling, linkage to care, and adherence services.

The goal of this guide is to provide up-to-date information and best practices for coding, billing, and denial resolution for PrEP and PEP services. Health department staff are encouraged to share this resource with grantees, community partners, and other health care providers billing for HIV prevention services.

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Tags: GuideBillingcodingHIVPrEPEnding the HIV EpidemicHIV screeningHIV prevention

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Acknowledgements

This resource collection was compiled by the HITEQ Center staff with guidance from HITEQ Advisory Committee members and collaborators of the HITEQ Center.