Quality

Goal Attainment Scaling

What outcomes should be used to measure if a medicine is a “good” medicine? Improved survival? Improved ability to function? Few side effects? Ability to get back to work? Living to attend your daughter’s wedding? All of the above? Oftentimes, health economists measure value of a treatment for the average person. Preferences for efficacy, safety, …

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Medicare Advantage vs. Medicare FFS: A Systematic Review

Medicare Advantage has grown over time. In 2020, nearly four in ten (39%) of all Medicare beneficiaries – 24.1 million people out of 62.0 million Medicare beneficiaries overall – were enrolled in Medicare Advantage (MA) plans. With MA enrollment growing, a key question is who provides higher quality care: Medicare fee-for-service (FFS) or MA? Who …

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Impact of COVID-19 on CMS’ value-based programs

Many Medicare payment initiatives aim to link reimbursement to value. Value includes both cost and quality of care. However, measuring quality of care during a pandemic is problematic. Further, most of CMS’ value-based purchasing programs–such as Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program (HRRP) and the Hospital-Acquired Condition (HAC) Reduction Program all …

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Limitations of CMS’s Hospital Star Ratings System

Is your hospital high quality? Well, this depends on what quality means. Does it have low readmission rates? Low rates of mortality? Do they follow clinical guidelines? Are patients satisfied? Are they good at cardiology care? What about cancer treatment? Combining all these different dimensions of quality is a complex task. The Centers for Medicare …

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Providers to HHS: ACO quality reporting changes create undue burdens

Eleven provider organizations sent a letter to HHS urging them to reconsider the new rules around quality measurement and reporting for ACOs. One of the reasons these rules are burdensome and should be revised is the lack of EHR interoperability, they said.

Is nursing home staff turnover a good quality metric?

There are a few sub-questions we need to break down to answer before answering this one larger question. These sub-questions include: Is nursing staff turnover at nursing homes a big problem? Is nursing staff turnover correlated with quality of care? Does using nursing staff turnover as a quality metric provide the right incentives? A paper …

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The Oncology Care Model is dead. Long Live the Oncology Care First Model.

The Oncology Care Model is slated to end soon. Specifically, the last set of six-month episodes would initiate no later than December 31, 2020 and thus all episodes will be completed in June 30, 2021. Nevertheless, CMS is proposing a successor to the Oncology Care Model called the Oncology Care First (OCF) Model. CMS describes …

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The Dawn of a European Health Data Space – Challenges

The European data strategy aims to construct common data spaces for all, create a single EU market for data, and catalyze a dynamic data economy. In a previous post, we briefly described the essence of the envisioned heath data space and pointed at opportunities and possible starting points to transform this vision into reality. However, …

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