Magazine article Medical Economics

Do Quality Metrics Actually Improve Medical Care?

Magazine article Medical Economics

Do Quality Metrics Actually Improve Medical Care?

Article excerpt

WITH MEDICARE and commercial insurers increasingly tying physicians' reimbursement to their ability to report on- and meet-outcome measurements, the question logically arises, is it working? Is the growing emphasis on quality and value having an impact on patient health, and/or healthcare spending?

The short answer is, it's too soon to tell. Still, intriguing-if scattered-evidence is beginning to emerge that it might be. For example:

-Medicare spending for 2014 was projected to be about $1,200 less per beneficiary than had been forecast in 2010, the year the Affordable Care Act was passed, according to a Kaiser Family Foundation study. The slowdown in spending is partially attributable to "reductions in provider payment updates and Medicare Advantage payments" as well as cuts resulting from the 2013 budget sequester, the authors say, while adding that "providers may be tightening their belts and looking to deliver care more efficiently in response to financial incentives included in the ACA, and it is possible that these changes are having a bigger effect than expected'.'

-The National Council of Quality Assurance found improvements in 46% of the 139 Healthcare Effectiveness Data and Information Set performance measures it tracked over the previous three to five years, performance declines in 8%, and mixed results or no trend in 46%.

-Medicare's evaluation of the first year of its Comprehensive Primary Care (CPC) initiative concluded that "CPC appears to have reduce total monthly Medicare Part A and B expenditures per beneficiary.... by $14, or 2 percent The reductions appear to be due to the favorable... …

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