Impact of star ratings on provider demand

For years, Medicare and other payers have used quality measures to evaluate the quality of care patients receive at various types of providers settings (e.g., hospital, home health agencies, skilled nursing homes). For some payers, higher quality scores/higher star ratings lead to direct increases in reimbursement through a value-based purchasing arrangement. Typically, value-based payment systems…

Measuring Hospital Quality

Quality of care is difficult to measure. Even if you had a perfect measure of quality in terms of health outcomes, risk adjustment is imperfect. For instance, academic medical centers are often assumed to have high quality, but actual outcomes observed in the data may not be that good if they also receive the sickest,…

Clinician-Directed Performance Improvement is the best way to improve quality…why won’t payers use it?

Goitein (2020) argues that Clinician-Directed Performance Improvement is the best way to improve quality. I agree. This approach empowers physicians and other health care professionals to identify areas for improvement and work on those. Clinician Directed Performance Improvement (CDPI)…had its origins in 2013, when a group of physicians requested support for a physician-led quality program…

Does the VA provide high-quality care?

This question is difficult to answer. In many countries with government provided health care, wait times are long. For the Veterans Affairs (VA) beneficiaries, this does not seem to be much of an issue according to a Penn et al. (2019) study covering wait times between 2014 and 2019: Although wait times in the VA…

How good is Nursing Home Compare?

In the past few weeks, I discussed how well Hospital Compare does on measuring the quality of hospital care (see here and here).  Now, I turn to how well Nursing Home Compare does on truly measuring quality of care.  A study by Brauner et al. (2018) attempts to answer this question.  They compare the quality…

Pharmacists as health care providers

Pharmacists are often seen as individuals who just dispense drugs.  However, pharmacists are increasingly considered as providers that are part of the broader health care team. My own research has shown that pharmacists are a more cost-effective and safe approach to getting vaccinations compared to primary care providers (see Fontanesi et al. 2009).  A Health Affairs Entry…