Quality Matters Archive

Quality Matters reported on emerging models and trends in health care delivery reform and interviews with leaders in the field. Please read its successor, Transforming Care.

  • October/November 2014 Issue
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News Briefs

Report: More Oversight of Medicaid Managed Care Needed to Ensure Access

Across states, Medicaid managed care beneficiaries have widely varying access to services—with per capita rates of primary care providers ranging from one per 100 beneficiaries in some areas to one per 2,500 in others, for example. This finding comes from a September report from the Office of the Inspector General of the U.S. Department of Health and Human Services that compared beneficiaries' access to care in 33 states. States are responsible for ensuring accessibility of care, using standards they determine that take into account the travel time/distance to see providers, wait times for appointments, and minimum provider-to-patient ratios, among other measures. The report notes that states' standards vary widely and may not take into account differences between urban and rural locations, or different types of providers. The authors recommend that the Centers for Medicare and Medicaid Services (CMS) strengthen oversight of state standards and offer states technical assistance to improve their methods of assessing compliance.

ONC's Roadmap to Interoperable Medical Records

Earlier this month, the Office of the National Coordinator for Health IT released the first draft of its roadmap to interoperability—which aims to ensure that providers can easily exchange medical information and reap the benefits of what is now fairly widespread electronic data collection. The roadmap, which will be available for public comment starting in January 2015, sets three-year goals for ensuring basic data exchange and 10-year goals for building a learning health system to promote population health.

One-Quarter of ACOs Earned Bonuses for 2013

About a quarter of the 243 accountable care organizations (ACOs) that participated in the Medicare Shared Savings and Pioneer programs reduced health care costs enough to earn bonuses from CMS last year. The ACOs made improvements on most of the 33 measures of quality and patient experience. CMS has published a list of the savings generated and bonuses earned here.

New HealthGrades Site Rates Doctors on Experience, Quality

The commercial physician rating tool, Healthgrades.com, has launched a much more comprehensive database to compare physicians based on their experience in a particular area or procedure, complication rates at the hospitals where they practice, and patients' reports of their experiences. The expanded site launched in mid-October, in time to be used by consumers during the November open enrollment period on federal and state health exchanges.

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