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Value-Based Healthcare Demands Upgrades to Core Quality Measures
The Core Quality Measures Collaborative Workgroup, initiated by AHIP and payer organizations, seeks to reduce, refine, and relate the healthcare delivery process.
At the recent Patient-Centered-Diabetes Care meeting hosted by The American Journal of Managed Care, Robert Gabbay, MD, PhD, of the Joslin Diabetes Center emphasized the importance of "measurements" for the success of their diabetes program. As the healthcare tide slowly changes to implement value in everyday care, reimbursement is being weaved with quality scores and outcomes.
In a recent blog post, Patrick Conway, MD, MSC, chief medical officer of CMS, wrote about how the Core Quality Measures Collaborative Workgroup was convened by America’s Health Insurance Plans and its member plans. The collaborative sees representation by CMS, the National Quality Forum, as well as national physician organizations. "Our goal is to promote a simplified and consistent process across public and private payers by reducing the total number of measures, refining the measures, and relating measures to patient health—known as the 3Rs (reduce, refine, and relate)," writes Dr Conway.
Read more on the Collaborative's plans to expand and include diverse stakeholders.
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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Integrated CKD Care Model Cuts ED Visits by 30%, Boosts Specialized Treatment
April 21st 2025An analysis of an interdisciplinary care model for managing chronic kidney disease (CKD) shows hospital admissions dropped by 26% and emergency department (ED) visits decreased by 30% after clinic initiation.
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