Monday Morning Medicaid Must Reads: October 8th, 2018

Helping you consider differing viewpoints. Before it’s illegal. 


Article 1:  

National Quality Forum identifies set of quality measures for rural providers, Paige Minemyer, FierceHealthcare, 9/18/2018

Clay’s summary: The specific needs of Rural Americans- finally a focus of pop health?

Key Passage from the Article

The set includes nine measures intended for a hospital setting—such as scores on the Hospital Consumer Assessment of Healthcare Providers (HCAHPS) survey and Cesarean section rates—and 11 for ambulatory care settings, such as medication reconciliation postdischarge and preventive screenings for diabetes, behavioral health issues and tobacco use.


Read it here 

Article 2:   

Health Care Quality: It’s Motherhood and Apple Pie. Until You Start To Measure It. Lola Butcher, Managed Care, 9/3/2018

Clay’s summary: You mean the government can’t write a reg to improve quality of care? And actually focuses on minutia that can be counted versus outcomes that matter? Egads! #Resist!

Key Passage from the Article

When he’s using microsurgical techniques to treat unbearable facial pain, neurosurgeon Richard Zimmerman, MD, values precision above all. But as the chair of quality outcomes at Mayo Clinic in Arizona, he has come to accept that the government’s system for measuring health care quality is less than precise.

“If you’re a hematologist–oncologist, the survival rate of cancer patients might be a better indication of quality than how often you document that you have screened for depression,” he says.

But screening a patient for depression—or, more accurately, documenting that you have screened for depression, regardless of whether you actually remembered to do so—leads to higher pay from the Medicare program. Nobody’s paying more for high cancer-survival rates.

Welcome to health care’s pay-for-value movement, in which public and private payers want to reward—and penalize—physicians based on the quality of care they provide.

It’s a good idea with a big problem: Physicians don’t believe in it.


Read it here 




Article 3:   

CMS: Better Data Analytics, Quality Measures will Modernize Medicaid

Clay’s summary: Looking forward to seeing the creativity of haters in coming up with a way this is a bad thing.

Key Passage from the Article

Modernizing the Medicaid program environment will require investments in data analytics and a greater reliance on meaningful quality measures, says CMS Administrator Seema Verma in a new blog post. As spending on healthcare in general – and Medicaid in particular – continues to rise, providers and regulators will need to continue to create more effective partnerships around raising quality and cutting costs, Verma stated. “As program costs have continued to rise, we have failed to deliver a level of transparency and accountability for achieving positive outcomes commiserate with our significant investment,” she wrote. “But this is finally beginning to change. Over the last several years, CMS has collaborated with states to improve how we collect and use data to modernize and measure the Medicaid and CHIP program.”


Read it here