Quality Measures

How Beneficiary Preferences Can Impact Hospital VBP Payment Incentives

June 28, 2023 - If the Hospital Value-Based Purchasing (HVBP) program value weights were based on Medicare beneficiary preferences, nearly $86 million in payment incentives would be reallocated and smaller rural hospitals would be penalized, according to a study published in JAMA Network Open. The HVBP program withholds 2 percent of hospital Medicare payments and...


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Study: Hospital Spends $5M Per Year on Quality Reporting

by Jacqueline LaPointe

Quality reporting is now a core function in healthcare, enabling value-based payment, transparency and accountability, and provider comparisons, to name a few benefits. However, quality data...

NAACOS Calls on CMS to Adjust Digital Quality Measurement Requirements

by Victoria Bailey

Before implementing program-wide requirements for digital quality measurement in the Medicare Shared Savings Program (MSSP), CMS should establish a pilot that tests the technical feasibility and the...

Are Readmission Rates The Best Measure of Hospital Quality?

by Jacqueline LaPointe

Readmission rates are one of the top measures of hospital quality, with most hospitals even putting their revenue on the line if they have excess hospital readmissions. However, a group of doctors...

CMS Releases Quality Measure Set to Improve Home, Community-Based Care

by Victoria Bailey

CMS has released a quality measure set for home- and community-based services (HCBS), aiming to promote consistent quality measurement and data collection in the Medicaid HCBS program and improve...

Daily Variation in Nursing Home Staffing Led to Poorer Clinical Quality

by Victoria Bailey

Daily variation in nursing home staffing was associated with poorer clinical quality in Medicare and Medicaid-certified nursing homes, suggesting that reporting staffing variation could help provide...

Most Group Practices Received Positive MIPS Scores For 2020 Payments

by Victoria Bailey

The majority of group practices that participated in Medicare’s Merit-Based Incentive Program System (MIPS) in 2018 received exceptional or positive performance scores for 2020 payment...

Top Challenges of the Merit-Based Incentive Payment System

by Victoria Bailey

The Government Accountability Office (GAO) analyzed performance data from providers who participated in the Merit-Based Incentive Payment System (MIPS) between 2017 and 2019 and found that some...

MIPS Quality Score Not Often Associated with Better Patient Outcomes

by Jill McKeon

Better Merit-based Incentive Payment System (MIPS) quality scores were rarely associated with lower rates of hospital complications during the first year of program implementation, according to a study...

NY Medicaid Program Bringing Value-Based Payment to Pediatrics

by Jacqueline LaPointe

New York is overcoming the challenges of developing value-based payment models for pediatrics to bring value to the approximately 1.8 million children enrolled in its Medicaid program, according to a...

Making APMs Truly Value-Based Through Person-Centered Care

by Jacqueline LaPointe

Each stakeholder brings their own definition of value to the table when developing alternative payment models, which incent providers through value-based payments to deliver care that aligns with the...

HHS Quality Summit to Examine Federal Value-Based Care Programs

by Jacqueline LaPointe

HHS recently announced the creation of the Quality Summit, which will bring together federal and private healthcare stakeholders to evaluate and streamline federal value-based care programs. The...

Quality Measure Change May Impact Medicare ACO Performance

by Jacqueline LaPointe

Medicare accountable care organizations (ACOs) performance may suffer after CMS unexpectedly modified a quality measure during the 2018 Medicare Shared Savings Program (MSSP) performance period, the...

Only 37% of MIPS Quality Measures Deemed Valid by ACP

by Jacqueline LaPointe

The American College of Physicians (ACP) is calling for a “time-out” to assess and improve Merit-Based Incentive Payment System (MIPS) quality measures after finding few of the measures...

AMGA: Link Spending, Quality Performance for True Value-Based Care

by Jacqueline LaPointe

In response to a Request for Information from the Assistant Secretary for Planning and Evaluation (ASPE), AMGA recently called on CMS to “define value in a meaningful way” to ensure...

Stakeholders Back Standard ACO Measures for Commercial Orgs in CA

by Jacqueline LaPointe

The Integrated Healthcare Association (IHA) and Pacific Business Group on Health (PBGH) recently embarked on a joint mission to standardize accountable care organization (ACO) measures for quality and...

The Pros and Cons of Quality Measure Choices In MACRA, MIPS

by Jacqueline LaPointe

Uprooting the fee-for-service payment system and changing the way clinicians provide care is no easy feat. With this in mind, CMS designed MACRA’s Merit-Based Incentive Payment System (MIPS) to...

MIPS Quality Reporting Flexibilities Trouble Providers, EHR Vendors

by Jacqueline LaPointe

It’s good to have options when it comes to the clothes we wear, cars we drive, and things we do. But having too many options when it comes to quality reporting under MACRA’s Merit-Based...

Cost Data to Improve Quality Reporting, Value-Based Purchasing

by Jacqueline LaPointe

Providers enter value-based purchasing contracts without understanding the cost of quality reporting on measures listed in their contracts and payers rarely use cost data to determine...

NQF Eyes Adding Social Risk Factors to Value-Based Purchasing

by Jacqueline LaPointe

In response to stakeholder concerns that value-based purchasing programs unfairly penalize providers who treat greater proportions of disadvantaged patients, the National Quality Forum (NQF) recently...