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Review of Medicare, Medicaid, and Commercial Quality of Care Measures: Considerations for Assessing Accountable Care Organizations.
- Source :
-
Journal of health politics, policy and law [J Health Polit Policy Law] 2015 Aug; Vol. 40 (4), pp. 761-96. Date of Electronic Publication: 2015 Jun 29. - Publication Year :
- 2015
-
Abstract
- Accountable care organizations (ACOs) have proliferated under the Affordable Care Act (ACA). If ACOs are to improve health care quality and lower costs, quality measures will be increasingly important in determining if provider consolidations associated with the development of ACOs are achieving their intended purpose. This article assesses quality measurement across public and private sectors. We reviewed available quality measures for a subset of programs in six organizations and assessed the number and domain of measures (structure, process, outcomes, and patient experience). Two-thirds of all quality measures were categorized as process measures. Outcome measures made up nearly 20 percent of measures. Patient experience and structure measures made up approximately 8 percent and 7 percent, respectively. We propose further improvements to quality measurement initiatives. For example, programs that reward providers should consider reward size and distribution within the organization. Quality improvement initiatives should consider what encourages provider buy-in and participation and the effects on populations with disproportionate health care needs. As the focus of quality initiatives may change from year to year, measures should be periodically revisited to ensure continued improvement and sustainability. Finally, we suggest quality measures that regulators could use prior to ACO formation or in the year or two following formation.<br /> (Copyright © 2015 by Duke University Press.)
- Subjects :
- Humans
Information Systems organization & administration
Medicaid standards
Medicare standards
Models, Organizational
Outcome and Process Assessment, Health Care methods
Patient Satisfaction
Quality of Health Care
United States
Accountable Care Organizations standards
Private Sector standards
Public Sector standards
Quality Improvement standards
Quality Indicators, Health Care standards
Subjects
Details
- Language :
- English
- ISSN :
- 1527-1927
- Volume :
- 40
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of health politics, policy and law
- Publication Type :
- Academic Journal
- Accession number :
- 26124294
- Full Text :
- https://doi.org/10.1215/03616878-3150050