Daman periodically measures and tracks clinical performance and outcomes through various performance metrics using the adjudicated claims data, where the quantitative parameters are compared to local and international benchmarks. These measures are based on international indicators and are used widely to monitor health outcomes and highlight concerns about medical care based on methodologies in line with industry best practices.

Daman has selected a series of metrics designed to evaluate the performance of health care providers. The metrics include:

• Clinical Metrics, that show the quality of clinical care the provider is administering. There are two categories within the clinical metrics:
• Process Metrics, that show whether evidence-based practices are followed correctly and evaluate whether a specific action was completed
• Outcome Metrics, that present the actual results of care and evaluate how well the provider is helping patients achieve good health
• Financial Metrics, that broadly captures indicators of cost and efficiency of health care provision.
• Structural Metrics, that reflect the conditions in which providers care for patients, and evaluate the capacity of the provider to deliver contracted health services.

Daman collects data on the clinical and financial metrics through claims submitted for patient services. Daman collects the structural metric data by observing the providers’ facilities, behavior, trend, and capabilities. A provider’s performance on applicable metrics will determine whether patients are receiving efficient and quality care.

Daman monitors provider performance on the metrics, and studies their correlation to broader health outcomes, such as patients’ quality of life, long-term health outcomes, and overall cost of care. Daman uses this analysis to refine the selection and weights of metrics and to provide performance feedback to providers.

Metrics Overview

Separate clinical, financial and structural scores are calculated that allow the providers to know their performance in these categories. The Clinical score is a composite score derived from Inpatient, Outpatient and Daycare Clinical scores. Click here to see the full list of the available metrics.

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