News
How Patient-Centered Outcomes Drive Care Transformation: The Arizona Coalition Model
February 2022
As many as 4 in 10 adult Americans have two or more chronic conditions like heart disease, cancer, chronic lung disease, stroke, Alzheimer’s disease, diabetes, and chronic kidney disease. Nationally, people with chronic and mental health conditions account for 90% of the 3.8 trillion dollars of health care expenditures. Many people with serious illness may…
HEDIS Public Comments and CMS Measure Submissions Are Open
February 2022
The Centers for Medicare and Medicaid Services (CMS) Measures Under Consideration Entry/Review Information Tool is now open for measure submissions via the CMS MERIT (Measures under consideration Entry/Review Information Tool). The CMS MERIT will remain open for submissions through Friday, May 20, 2022. Additionally, the National Committee for Quality Assurance announced that the HEDIS measures…
Medicare Seeks Feedback on Specialist Physician Measure Sets
January 2022
The Centers for Medicare & Medicaid Services, the agency that runs Medicare, is accepting stakeholders’ recommendations for measures used to evaluate specialist physician practices. As part of Medicare’s Quality Payment Program (QPP), these measures influence clinical priorities and patterns of care to align with best practices. An example of a specialty measure is Statin Therapy,…
Using Quality Tactics to Advance Value-Based Oral Health Care
January 2022
Despite the overall shift towards value-based care within the US health care system, adult oral health is often overlooked in terms of quality measurement, hindering efforts towards value-based oral health care (VBOHC). On October 22, 2021, Discern Health, GlaxoSmithKline (GSK) Consumer Health, and The Gerontological Society of America (GSA) convened an Oral Health Quality Expert…
Cost-Effectiveness of Pneumococcal Conjugate Vaccines 13 and Its High Impact in Public Health in Chinese Cities
January 2022
Pneumococcal disease (PD) is a serious public health problem in China with an estimated 30,000 deaths per year. Studies have reported the cost-effectiveness of pneumococcal conjugate vaccines (PCV) in China, yet they are not well characterized in specific cities at present. An economic model was implemented to evaluate the cost-effectiveness of 70% of vaccination with…
Lessons from COVID-19: Prioritize Infection Prevention and Control for PALTC
January 2022
Post-acute and long-term care (PALTC) residents, staff, and leaders across the United States have faced a multitude of challenges during the COVID-19 pandemic. Despite these challenges, the pandemic also taught many lessons and created opportunities to improve quality. Real Chemistry Vice President Theresa Schmidt led her fellow board members in the Advancing Excellence in Long-Term…
Shaping Value-Based Care in 2022
January 2022
Look out for these anticipated key quality and value events in 2022. These rules, regulations, public comment periods, stakeholder meetings, and other events present strategic opportunities to engage with thought leaders and decision-makers that impact payer, employer, provider, and patient behavior. 2022 Q1 January – Public Comment: NCQA Health Plan Ratings 2023 (due Jan 10) January…
Medicare Updates Physician Quality Program
December 2021
In November, CMS issued annual updates to the Medicare Quality Payment Program (QPP), which links physician payment to performance on cost, quality, and patients’ experience of care. Most physicians in the country participate in the QPP, and the program’s measures influence care decisions and population health priorities. Notably, CMS affirmed its goal to use the…
Using Quality Measures to Drive Improvements in Immunization Rates
December 2021
Adult immunization rates are low and continue to fail to meet national targets. The coronavirus disease 2019 pandemic halted routine health care services for many, including vaccinations. In collaboration with the American Medical Group Association and GlaxoSmithKline, Discern Health presents findings from a real-world evaluation of three US health care organizations in a new Population…
Assessing Opportunities to Advance Quality Measures in Adult Obesity
December 2021
Obesity is a serious chronic disease in the United States. From 2017 to 2018, the age-adjusted prevalence of obesity in adults was 42.4%, with no significant differences between men and women among all adults or by age group. In a new American Journal of Managed Care article, Director Kaitlyn Esselman, Senior Project Manager Tess Donckels,…