Link: What Are The 9 Reasons to Stop Scoring Patient Experience?
The above link is a post from Paul Roemer on quality measurement from the patient's perspective. Although he brings up a few good points about the timeliness and validity of the CAHPS® Survey, monitoring and measuring the quality of care provided to ACO Beneficiaries is directly correlated to a revenue gain or bust. Of particular interest in Paul's post is the need to compare your scores, question by question (or measure by measure), against average scores for other health systems.
The ability to analyze your performance against the performance of like entities provides a data-driven, procedural approach for analyzing the delivery process. Clearly, population management relies on data-driven methods to analyze and identify high-risk members and allocate services.
So, prior to developing the ACO Quality Measure Checklist, I took a random sample of ACOs and looked at their performance on the Quality Measure Scores. There was significant variation in the results between ACOs as well as the national mean. Recently I took a random sample of ACOs and looked at their performance on the Quality Measure Scores. There was significant variation in the results between ACOs as well as the national mean.
You can make your own conclusions...
This first domain of the Patient/Caregiver Experience shows very little variation between ACOs and against the national mean. The quality measures in this domain may easily be implemented by different practitioners.
The domain of Care Coordination and its metrics begin to show some variation with the last three measures. Note the continuity of the selected ACOs for Figure 14 Care Coordination. An interesting occurrence is spot-on performance for ACO Measures 8 through 10. Items 12 and 13 show variation where it might not be expected. Medication Reconciliation and Screening for Fall Risks are two standard activities for new patients, patients admitted to hospitals, and regular screening procedures for primary care. Note the mean performance rate for all ACOs.
Now, in the domain of Preventive Health we see some significant variation that is most likely due to the fact that primary care Physicians have not previously been compensated for preventive health and associated interventions. Influenza and Pneumococcal Vaccinations are standard for individuals ages 65 and over unless contraindicated. Adult weight screening and individuals with Diabetes are another area of interest. Tobacco, colorectal, mammography and blood pressure screening should be a standard practice for primary care. Note the mean performance rate in bold for all ACOs.
And finally, in the domain of the At-Risk Population there is widespread gaps and variation in the process of care for ACO Beneficiaries with chronic conditions. Because regulations state that avoidance of At-Risk populations is cause for termination of an ACO, the population of beneficiaries that qualify for measures 22 through 33 should correlate to the number of beneficiaries with associated diagnoses or comorbid conditions. Note the mean performance rate for all ACOs.
Data Source: "Medicare_Data_to_Calculate_Your_Primary_Service_Areas." Centers for Medicare and Medicaid. Centers for Medicare and Medicaid, 2012. Web. 14 Feb. 2015. http://www.cms.gov/Medicare/Medicare-Fee-for-Service-payment/sharedsavingsprogram/Calculations.html.
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