CMS Pushing Streamlining Of Quality Measurement
Interesting article on the Centers for Medicare and Medicaid Services’ (CMS) push to streamline quality metrics across programs. Its approach, called the Universal Foundation, is meant to ease complexity, burden, and the administrative costs on providers and health plans by establishing standardized metrics and financial incentives. Right now, CMS has about 20 measure sets that encompass hundreds of discrete measures.
I certainly endorse standardization and streamlining, but migrating to the Universal Foundation will take years. Further, given differences in demographics, we will always have some unique measures in each program. But standardizing Accountable Care Organization (ACO) and Medicare Advantage (MA) measures would be a great place to start.
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#quality #stars #acos #medicareadvantage #cms
https://www.modernhealthcare.com/policy/cms-universal-foundation-quality-data-reporting-measurement
What Might HHS Look Like Under RFK Jr.
An interesting article on what might occur under the Trump administration as Robert F. Kennedy Jr. pursues reforms at the Department of Health and Human Services (HHS) and subordinate agencies in his efforts to Make America Healthy Again.
In related news, a new Congressional Budget Office (CBO) report looks at potential economic impacts from artificial intelligence (AI), including in healthcare. CBO says it is unclear if the use of AI will increase or decrease federal spending.
Additional article: https://insidehealthpolicy.com/daily-news/cbo-unclear-if-ai-use-will-increase-decrease-federal-health-spending
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#hhs #rfkjr #healthcare #maha
Winners and Losers From Stop Gap Bill Passage
The biggest loser in the skinny stop-gap funding bill is likely Medicare physicians who received no deserved rate relief and now face a 2.8% reduction. Pharmacy benefits managers (PBMs) have received what is likely just a short-term reprieve or win. By and large, the stop gap bill had very closely tailored healthcare measures to extend the status quo.
Another article bemoans the fact that any kind of Medicare physician doc fix was stripped from the stop gap. As the article notes, Medicare physicians have been given short shrift for decades now, with real payments being reduced by 33% over the past two decades. See my blog on the huge injustice: https://www.healthcarelabyrinth.com/docs-need-rate-relief-in-medicare-program/ .
Additional article: https://www.medpagetoday.com/publichealthpolicy/washington-watch/113521
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#crs #governmentshutdown #healthcare
PACE Gets Infusion Of Private Enterprise
The PACE program, the decades old Medicare and Medicaid long-term care pilot, is attracting tech-savvy private investors. Faced with a requirement for heavy investments and short-term losses, the program could see some reinvigoration and expansion, although critics will question the profit motive.
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#medicaid #medicare #longtermcare #pace
Health Affairs Forefront Blog Reviews Pending ACA Preventive Services Challenge
Health Affairs Forefront Blog reviews the pending appeal related to the legality of the preventive services mandate in the Affordable Care Act (ACA). At issue is whether one or more agencies of the federal government meet the requirements of delegated authority to recommend covered services. Opponents of the mandate have won partial victories in a lower court and the Biden administration has appealed. About 150 million people benefit from zero-cost sharing preventive services.
(Article may require a subscription.)
#aca #obamacare #prevention
— Marc S. Ryan
