Tag Archives: quality measures

HHS “Quality Summit” to Focus on Overhauling Federal Quality Programs

The Department of Health and Human Services (HHS) has announced plans to hold a “Quality Summit” to foster dialogue between government leaders and health care industry stakeholders on how HHS quality programs “can be further evaluated, adapted, and ultimately streamlined to deliver a value-based care model focused on improving outcomes for American patients.”  Ultimately, the … Continue Reading

MedPAC Issues Annual Report to Congress on Medicare and the Health Delivery System

The Medicare Payment Advisory Commission (MedPAC) has released its annual report to Congress on “Medicare and the Health Care Delivery System.” This year’s report includes recommendations for changes to emergency department services policies, along with analyses of potential changes that would impact physicians, medical equipment suppliers, post-acute care providers, and others.  Highlights include the following:  … Continue Reading

CMS Proposes FY 2019 Medicare IPPS/LTCH Rates and Policy Changes

The Centers for Medicare & Medicaid Services (CMS) has published its proposed rule updating the Medicare acute inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) for fiscal year (FY) 2019. The proposed rule also includes a request for information (RFI) on ways CMS can enhance interoperability in the health … Continue Reading

CMS IMPACT Act Educational Calls – Focus on Care Coordination (Sept.15) and Data Elements (Oct. 13)

CMS has scheduled a September 15, 2016 Special Open Door Forum call on the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). This call will provide an overview of the IMPACT Act’s requirement for standardization of patient assessment data across post-acute care settings, and solicit input on the ways the IMPACT Act can help improve … Continue Reading

Energy & Commerce Committee Hearing to Focus on Physician Preparation for MACRA Reforms (April 19)

On April 19, 2016, the House Energy and Commerce Subcommittee on Health is holding a hearing entitled “Medicare Access and CHIP Reauthorization Act of 2015: Examining Physician Efforts to Prepare for Medicare Payment Reforms.”  The hearing will focus on major physician organizations’ investments in the development of alternative payment models, quality measures, and practice improvements.… Continue Reading

CMS, AHIP Release Multi-Payer Physician Quality Measure Sets

CMS and America’s Health Insurance Plans (AHIP) recently released seven sets of physician clinical quality measures as part of a “Core Quality Measures Collaborative” intended to align quality measures among payers and reduce the reporting burden on providers. Through the Collaborative, CMS, various commercial plans, Medicare and Medicaid managed care plans, purchasers, and provider and … Continue Reading

CMS Seeks Comments on Draft Physician Fee Schedule Quality Measure Development Plan

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to develop quality measures that will apply to Medicare payments to physicians when new Merit-based Incentive Payment System (MIPS) and Medicare alternative payment model (APM) provisions go into effect (MIPS and APM payment adjustments begin in 2019).  Pursuant to this mandate, CMS has … Continue Reading

CMS to Host Call on Implementation of the IMPACT Act

On October 21, 2015, CMS is hosting a provider call to discuss the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014.  The call will cover: Legislative requirements of the IMPACT Act related to the use of standardized data, quality measures, and resource use and other measures for skilled nursing facilities, inpatient rehabilitation facilities, long-term … Continue Reading

CMS to Host Webinar on Medicaid HCBS Quality Measures (Sept. 9)

On September 9, 2015, CMS is hosting a webinar on the development of quality measures for Medicaid fee-for-service beneficiaries using home- and community-based services (HCBS).  Specifically, the webinar will discuss efforts to establish measures of potentially avoidable hospitalizations due to:  severe pressure ulcers; acute ambulatory care sensitive conditions (e.g., dehydration, urinary tract infections); and chronic … Continue Reading

MedPAC Report to Congress on Medicare and the Health Care Delivery System

The Medicare Payment Advisory Commission (MedPAC) has released its June 2015 Report to the Congress on Medicare and the Health Care Delivery System. The report includes a series of recommendations on Medicare hospital short-stay policy, in response in part to hospital concerns about related Medicare Recovery Audit Contractor (RAC) Program audits and appeals and the … Continue Reading

CMS Publishes Corrections to 2015 Medicare Physician Fee Schedule Final Rule

CMS has published corrections to its final 2015 Medicare physician fee schedule rule. Among other things, the rule reflects a previously-announced correction to the conversion factor for the first quarter of 2015 ($35.7547), revises the April 1 – December 31, 2015 conversion factor to $28.1872 (assuming that Congress does not take action to avert this … Continue Reading

CMS Report Assesses Effectiveness/Impact of Medicare Quality Measures

CMS has released the “2015 National Impact Assessment of Quality Measures Report,” which examines the effectiveness of quality measures used in CMS hospital, ambulatory, and post-acute quality programs. The report found that 95% of 119 publicly reported measure rates across seven quality reporting programs showed improvement from 2006 to 2012, with process measures most likely … Continue Reading

MedPAC Voices Concerns about Growing Volume, Burden of Medicare Quality Measures

In December 2014, CMS released a 329-page list of quality measures under consideration for the Medicare program. In a January 13, 2015 comment letter, MedPAC observes that volume of measures under consideration “reinforces our concerns that Medicare’s provider-level measurement activities are accelerating without regard to the costs or benefits of an ever-increasing number of measures.” MedPAC suggests that … Continue Reading

MedPAC Meeting on Medicare Policies (Jan. 15-16)

On January 15-16, 2015, the Medicare Payment Advisory Commission (MedPAC) is meeting to discuss a number of Medicare topics, including, among others: post-acute care trends; payment updates for a number of provider types; relative costs of Medicare Advantage, accountable care organizations, and fee-for-service Medicare; hospital short stay policy; and quality measurement. … Continue Reading

CMS Solicits Suggestions for Potential PQRS Measures

CMS is inviting quality measure suggestions for potential use in the Physician Quality Reporting System (PQRS) and other physician quality programs. Measure suggestions will be accepted on an ongoing basis, with measures submitted prior to June 15, 2015 eligible to be considered for inclusion in the PQRS as early as 2017.… Continue Reading

CMS Plans Medicare Quality “Star” Ratings for Hospitals, Dialysis Facilities, Home Health

On June 18, 2014, CMS announced in a blog posting that it is planning to add a “Five Star” quality rating system to the Hospital Compare, Dialysis Facility Compare, and Home Health Compare websites on Medicare.gov. The agency will start making the new quality ratings available later this year and into early 2015. CMS already maintains … Continue Reading

GAO Offers Recommendations for Improvements to CMS Physician Feedback Efforts

A recent GAO report looked at how private health care entities provide performance data to physicians, and how such practices could be used to improve CMS efforts to provide feedback to providers. The GAO determined that the nine health insurers and statewide collaboratives it reviewed typically employ multiple benchmarks (e.g., peer group averages or past … Continue Reading

CMS Issues Call for PQRS Quality Measures

On May 1, 2014, CMS will begin accepting recommendations for potential Physician Quality Reporting System (PQRS) quality measures for 2016 and future rulemaking years. Quality measure proposals also will be considered for use in other physician quality programs, including the Value Based Modifier, Physician Compare, and the Medicare Shared Savings Program.… Continue Reading

MedPAC Meeting to Address Various Medicare Payment Policies (March 6-7)

On March 6-7, 2014, the Medicare Payment Advisory Commission (MedPAC) is meeting to discuss a number of Medicare payment and policy issues, including: site-neutral payments for select conditions treated in inpatient rehabilitation facilities and skilled nursing facilities; developing payment policies to promote the use of services based on clinical evidence; measuring quality in Medicare delivery … Continue Reading