he New York State Health Home Program has a five-page list of goal-based quality measures collected to assess the program’s success. Here is an abbreviated list of the goals and what is being collected and measured:

Goal 1: Reduce utilization associated with avoidable (preventable) inpatient stays.

- Clinical outcomes.

- Experience of care.

- Quality of care.

Goal 2: Reduce utilization associated with avoidable (preventable) ED visits.

- Clinical outcomes.

- Experience of care.

- Quality of care.

Goal 3: Improve outcomes for persons with mental illness and/or substance use disorders.

- Clinical outcomes, including mental health utilization and follow-up after hospitalization for mental illness.

- Experience of care.

- Quality of care, including antidepressant medication management and adherence to antipsychotics for individuals with schizophrenia.

Goal 4: Improve disease-related care for chronic conditions.

- Clinical outcomes.

- Experience of care.

- Quality of care, including medication management for people with asthma, and comprehensive diabetes care.

Goal 5: Improve preventive care.

- Clinical outcomes.

- Experience of care.

- Quality of care, including chlamydia screening in women, and colorectal cancer screening.

Source: http://on.ny.gov/2ck4QXa.