HEDIS Changes Reflect Focus on Health Equity

August 1, 2022acohealth equity, HEDIS, quality measures, SDOH

The nonprofit National Committee for Quality Assurance has revised quality measures for health plans in the Healthcare Effectiveness Data and Information Set (HEDIS) for measurement year 2023. NCQA has added race/ethnicity stratifications and made revisions to acknowledge and affirm member gender identity. Collecting race and ethnicity data is key to improving health disparities, NCQA said….

Diabetes care quality measures must be improved, study finds

July 22, 2022acochronic disease, diabetes, diabetes care, diabetes management, quality measures

Existing diabetes quality metrics do not currently help patients improve their health and diabetes quality measurement must be improved through the adoption of new measures and modernization, according to a June report published in Health Affairs. Current quality measures do not safeguard against inappropriate treatment or overtreatment and in fact incentivize providers to focus on…

For ACOs, the Question Is: To eCQM or Not to eCQM?

May 4, 2022acoACOs, eCQM, quality measures

By 2025, accountable care organizations will be required to do quality reporting via electronic clinical quality measures (eCQMs). Maria Alexander, senior director of population health at Mount Sinai Health System in New York, recently spoke about the pros and cons of reporting via eCQMs during the voluntary transition period between now and then. The Centers…

Quality measures don’t match patient-reported outcomes in inpatient behavioral health

November 10, 2021Garrett SchmittNo CommentsBehavioral Health, inpatient behavioral health, JQQ, mental health, NAQH, patient experience, patient outcomes, patient reports, Patient Satisfaction, psychiatric hospitals, quality measures, quality of care, self-reported outcomes, SROs

At psychiatric hospitals and other inpatient behavioral health facilities, good performance on routine quality measures does not necessarily lead to improvement in symptoms and other patient self-reported outcomes (SROs), reports a study in the November/December issue of the Journal for Healthcare Quality (JHQ), the peer-reviewed journal of the National Association for Healthcare Quality (NAHQ). “[O]ur analyses suggest…

Small primary care practices that received training in quality measures to enhance care improved patient outcomes

November 9, 2021Garrett SchmittNo Commentsenhanced care, patient outcomes, PCPs, Primary Care, primary care practices, quality measures, training

A team of family medicine researchers conducted an assessment to determine if the implementation of policies and workflows designed to improve quality of care in smaller primary care practices was associated with improved health outcomes for patients with cardiovascular disease. The study also examined whether enhancements in quality improvement capacity are associated with a change…

The Fundamentals of Medicare Advantage Star Rating Methodology

August 10, 2021Garrett SchmittNo CommentsCMS, Medicare, Medicare Advantage, Medicare Advantage Star Rating, quality measures, quality of care

The way to determine the quality of a Medicare Advantage health plan is simple: look at the five-star rating on the Medicare website. However, the Medicare Advantage Star Rating methodology that produces that star indicator is much more complex. A Medicare Advantage plan is a private payer health plan which the federal government funds and…

Maximize Your Value-Based Care Bottom Line

June 22, 2021Garrett SchmittNo Commentsbottom line, quality measures, SDOH, value-based care, vbc, VBC models

The transition from traditional fee-for-service (FFS) payments to valuebased reimbursement models is fundamental to the future of healthcare. Rather than rely on the number of tests or procedures to inform financial reimbursement, value-based care (VBC) models incentivize providers to deliver on three components: improving the patient care experience, improving the health of populations, and reducing…

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