MSSP Program May Add New Quality Measures
"We believe the measures chosen are more outcome-oriented and would ultimately reduce the reporting burden on ACOs," CMS officials say in the proposed rules.
Tomas Mikuckis, a principal specializing in health and life sciences at New York, NY-based management consulting firm Oliver Wyman, says there are "three notable trends" in the quality measures set to be added to MSSP:
- An increasing focus on patient outcomes rather than process measures, which will require ACOs to increasingly demonstrate that their activities are having measurable impacts on patient health
- The emphasis on chronic condition management, which "makes a lot of sense" given the large prevalence of chronic conditions in the senior population and the disproportionate impact these conditions have on health costs
- The skilled nursing facility measure could demonstrate CMS's willingness to hold the ACOs accountable for patient care across care settings and even at providers that are not formally part of the ACO
The proposed Medicare B rules also seek to provide incentives for MSSP ACOs to improve their quality measure scores from year-to-year. The incentives would be provided in addition to the program's standard gain-sharing calculation mechanism.
"ACOs that demonstrate quality improvement on established quality measures from year to year will be eligible for up to 2 bonus points per domain," say the proposed rules.
- EHR Systems 'Immature, Costly,' AMA Says
- Anthem Blue Cross, 7 CA Health Systems Create New Challenger, Business Model
- Interstate Medical Licensure Effort Advances
- Data Points to Boom in Private HIX
- Better HCAHPS Scores Protect Revenue
- How to Build a Health Plan from Scratch
- Few Winners Among MSSP Participants
- Technology Lights Up Health Innovation Forum
- Insurers see cost hikes in Partners HealthCare (MA) mergers
- Programs focus on high-risk patients to reduce spending