The Pharmacy Quality Alliance (PQA) has a new pharmacy performance measure that evaluates adherence to medications for diabetes, renin angiotensin system antagonists for hypertension, and statins for high cholesterol through a single composite measure.1 Although many might think the PQA already had member-endorsed adherence measures for these medications, the situation is a bit nuanced. There…
Attend any healthcare conference and you’ll quickly discover that it’s become downright fashionable for healthcare leaders to talk about their unwavering commitment to “value-based care.” The expression has become ubiquitous in healthcare circles. Its virtuousness goes unchallenged. But should that be the case? Michael E. Porter and Elizabeth Teisberg (with whom I worked as a…
For health care providers and payers, changes to the Stark Law, the Anti-Kickback Statute, and the reimbursement landscape encourage providing care that addresses social determinants of health for certain patient populations. Research shows that when medical care is delivered alongside non-medical services that affect health, patients, providers, and the health care system overall are better…
The Pharmacy Quality Alliance (PQA) has a new pharmacy performance measure that evaluates adherence to medications for diabetes, renin angiotensin system antagonists for hypertension, and statins for high cholesterol through a single composite measure. Although many might think the PQA already had member-endorsed adherence measures for these medications, the situation is a bit nuanced. There…
More than half of nurses are burned out. The consequences are severe. Even before the COVID-19 pandemic, nurses around the country reported feeling overworked and burned out. Burnout, characterized by energy depletion or exhaustion, job-related feelings of negativism or cynicism, and reduced professional efficacy, is not unique to nurses, with other types of health professionals…
New bipartisan legislation introduced in the House aims to reform Medicaid to enable the use of value-based purchasing agreements in Medicaid. The Medicaid VBP Act, released Tuesday, aims to ensure new treatments such as gene therapies would be administered under Medicaid via a value-based agreement that reimburses drug makers based on the outcomes the drug provides….
Starting in January 2023, health care payment policy will take an important step toward health equity. Last month, the Centers for Medicare and Medicaid Services (CMS) announced a new accountable care model that replaces the prior Directing Contracting models and incorporates changes to help organizations address equity and access through accountable care organization (ACO) participation….
Health systems, hospitals, and community health clinics have a substantial part to play in patients’ lives. As trusted sources of healthcare and information, US providers may help patients understand the links between unmet basic needs—or social determinants of health (SDOH)—and health while supporting patients in meeting these needs (see sidebar, “Unmet basic needs and other…
The American Hospital Association (AHA) has launched its Health Equity Roadmap, a resource to support hospitals and health systems. The road map consists of three parts: an equity transformation assessment, a customized action plan and a virtual community of peers. The resource is meant to meet providers where they are in their equity journey, the…
Hospice providers are seeking greater clarity when it comes to quality incentives in the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) program. Introduced in late February, ACO REACH replaces the Global and Professional Direct Contracting (GPDC) models. CMS indicated that the program reflects its refreshed priorities for payment system demonstrations. Among…