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How to Evaluate Physician Performance Using Appropriateness

March 30, 2022Sam Crow, Erica DeBaggis, and Rachel PlummerCareJourneyPredictive Modeling,Patient Engagement & Access,Risk Stratification,ACO REACHCareJourney

Appropriate Care: What’s the big deal?

It is well known that the United States spends more than any other nation on healthcare, but as a nation, our health outcomes miss the mark. As evidence-based medicine evolves, it is important that our healthcare practices adapt. With burnout at an all-time high and staff shortages on the rise, appropriate care helps health systems stay on track and care for their patient populations more effectively.

What is considered an “appropriate” definition?

In recent years, momentum among Accountable Care Organizations (ACOs) to improve health equity has increased. The Centers for Medicare & Medicaid Services’ announcement of the redesigned ACO REACH contracting model to improve health equity will only accelerate this momentum.

In this blog, we will help ACOs and healthcare payers understand how healthcare analytics can be used to identify health equity challenges and track improvement initiatives’ progress.

What is Health Equity

The White House and CMMI define the term “equity” as the consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; LGBTQ+ persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.

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: CMMI, CMS, Physician Engagement, physicians, SDOH

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