Assessment finds missing measures in Medicare’s pay-for-quality programs

A new assessment from Avalere on quality measures finds many important medical conditions are not represented in Medicare's pay-for-quality programs, which, in turn, limits Medicare's ability to pay for value.

For example, for many people with chronic conditions, including cancer, effective quality measurement remains intangible. In a graph in the Avalere assessment, conditions such as diabetes and chronic renal disease have as many as 21 impact condition measures, while prostate and lung cancer have only three.

"Quality measures are increasingly driving the economics of Medicare Advantage and other coordinated care programs," said Avalere CEO Dan Mendelson in a release. "As Medicare and other payers move towards value-based payments for services and pharmaceuticals, we need more meaningful quality measures in oncology and selected other areas of medicine to ensure alignment."

Read the entire assessment here.

Related article:

CMS: Proof lacking that quality measures have unintended effects

Megan Combs

Megan Combs was Associate Editor of I Advance Senior Care / Long Term Living from 2013-2018.