ACO Provider Performance Analysis

Accountable Care Organization Provider Performance Analysis includes comparative measurement, over time, of providers’ quality, appropriateness, efficiency and outcomes of care and the patients’ satisfaction with that care, as needed to inform practice improvement efforts and support fair allocation of incentive resources.

Graph 2018 Total Low Value Services in MA compared to Traditional Medicare by Plan

Anthem and other Blue MA Plans are worse than traditional Medicare in use of Low Value Services

In the November 1, 2024 issue of JAMA, Ciara Duggan and others from Harvard and Brigham published a paper evaluating the utilization of “low value services” across major Medicare Advantage insurers and Traditional Medicare. Low value services utilization was defined based on the Choosing Wisely campaign and the US Preventive Task Force, and incorporated in

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Picture of studying for a test

Physicians want fewer quality measures, but more might be better if it motivates core process improvement rather than “studying for the test”

A JAMA study reports that PCPs are contractually held accountable for 57 unique quality metrics and asserts that is “oversaturation.” I have disagreed with the premise that we need fewer measures. On the contrary, I believe that we actually need a lot more measures to finally convince health care provider organizations to stop trying to “study for the test” and to actually learn the subject and improve the core processes that drive health care quality.

Physicians want fewer quality measures, but more might be better if it motivates core process improvement rather than “studying for the test” Read More »

Hospitalists have been focused on reducing hospital length of stay, but not so much on smooth transitions to ambulatory care

A new study published in the  Annals of Internal Medicine compared the economic outcomes of hospital episodes managed by hospitalists to those managed by the patients’ primary care physicians in a Medicare population. Previous studies focused only on the cost of the hospital stay itself, and showed that hospitalists were able to reduce length of stay

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How to get a clearer picture of economic performance: Standard Cost and Payer Neutral Revenue

This morning, I read a set of slides published by the American Hospital Association (AHA) and the Health Research and Education Trust (HRET) called “Striving for Top Box: Hospitals Increasing Quality and Efficiency.” The report showcased the clinical integration and performance improvement efforts of three hospital-based health systems: Novant (North Carolina), Piedmont (Georgia) and Banner (Arizona).

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