CMS Quality Performance Results
Discover insights on CMS quality performance results by Gerald F. Kominski, Ph.D., including range of MSSP quality scores, quality differences by ACO type, performance by quality indicator, and quality differences by region. Gain valuable knowledge on balancing clinical and financial integration within ACO partnerships to improve population health outcomes.
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CMS Quality Performance Results Gerald F. Kominski, Ph.D. Professor, UCLA Fielding School of Public Health, and Director, UCLA Center for Health Policy Research May 8, 2015
Dimensions of CMS Quality Measurement for ACOs
Range of MSSP Quality Scores, Year 2 N=220 Source: Muhlestein D, Hall C. ACO Quality Scores: Good But Not Great. Health Affairs Blog, December 18, 2014.
Quality Differences by ACO Type (N=75) (N=26) (N=119) Source: Muhlestein D, Hall C. ACO Quality Scores: Good But Not Great. Health Affairs Blog, December 18, 2014.
Summary of Performance by Quality Indicator MSSP ACOs improved on 30 of 33 quality measures in Year 2 (2014) ACOs with physician and hospital groups had the highest scores for 13 of the 33 quality measures Shared decision making (#6) and qualifying for an EHR incentive payment (#11) were two measures where this ACO type had the largest advantage In contrast, physician group ACOs had the lowest scores on 24 of 33 quality measures This ACO type was substantially lower on composite scores for diabetes (#22-26) and CAD (#32-33) The 2 ASC measures (#9 and #10) had by far the lowest average scores (low 20s) among the 33 quality measures
Quality Differences by Region Source: Muhlestein D, Hall C. ACO Quality Scores: Good But Not Great. Health Affairs Blog, December 18, 2014.
Balancing Clinical and Financial Integration Effective partnerships are clearly an important ingredient in achieving clinical and financial integration In my opinion, clinical integration has to take precedence, because it requires building a shared culture, an enormous challenge even in the best of circumstances Relational coordination theory, which posits that successful coordination requires shared knowledge, shared goals, and mutual respect (Gittell, 2006; Gittell & Weiss, 2004), may be an effective framework for assessing the effectiveness of ACO partnerships Realistically, the full Triple Aim, though desirable and critical, may be beyond the scope of ACOs, at least in the near term Population health improvement will be the most elusive component if you believe in the social determinants of health
