CMS must learn from implementation of new quality measure sets as it refines and expands the Core Quality Measure Collaborative, Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.
CMS must learn from implementation of new quality measure sets as it refines and expands the Core Quality Measure Collaborative, Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.
Transcript (slightly modified)
What is next for the Core Quality Measure Collaborative to continue the transition to value-based payments?
So we put out seven core sets earlier this year, we’re really excited about that, but we really see that as the very first step. This work is nowhere near done, even with those seven sets. Those seven sets of measures were based upon existing quality measures. There’s ongoing measure development and as new measures come along in the primary care space, oncology, cardiology, which are three of the seven core sets, we’ll need to take a look at those and see if they’re better measures than the ones that are in there now. So there’s going to be an ongoing iterative process with the existing seven sets, to further refine them as we learn from implementation.
As we implement these seven core sets, us at CMS through the Medicare program but also the commercial payers, we know from experience that there’s always unintended consequences, both good and bad, that happen whenever you’re implementing something new. So we need to be monitoring how this implementation goes, what worked well, what didn’t, and then mid-course correct when we find what didn’t go well.
So I think for the Core Measures Collaborative, a couple of things. We’re going to be monitoring how this goes, we’re going to be refining the sets that we already have, and we’re probably going to be delving into some new topic areas. For example, there’s actually a work group right now working on alignment of pediatric core measures, so we’re really excited about that; hopefully that can be announced relatively soon. We’ve been approached by a number of specialty societies that are very interested in us taking on topics within their area of specialty. So we have to determine what those will be, we haven’t decided that yet, but we will undoubtedly also be taking on new topics soon.
IgE Mediation in Pediatric Atopic Dermatitis, Concurrent Immune Disorders: Amy Paller, MD
August 4th 2025Amy Paller, MD, pediatric dermatologist and clinical researcher at Northwestern Medicine's Feinberg School of Medicine, discussed the potential impact of reducing immunoglobulin E (IgE) levels in pediatric patients with atopic dermatitis.
Read More
Legal Navigation Services Key to Addressing Disparities in Cancer Care
July 31st 2025A significant number of patients with cancer, caregivers, and health care professionals face significant disparities in legal issues, with the most common needs revolving around health insurance, finances, employment, and disability insurance.
Read More
The Legal Architecture of Psychedelic Therapy: Risks, Responsibilities, and Reimbursement Realities
July 30th 2025Key legal, ethical, and compliance considerations for managed care professionals navigating the evolving landscape of psychedelic-assisted therapy include regulatory risks, data privacy challenges, reimbursement limitations, and the need for culturally informed care models.
Read More
Managed Care Reflections: A Q&A With Charles N. (Chip) Kahn III, MPH
July 30th 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The August issue features a conversation with Charles N. (Chip) Kahn III, MPH, the president and CEO of the Federation of American Hospitals and a longtime member of the AJMC editorial board.
Read More