As federal health reform legislation has stalled, health policy attention turns to the states, which have many tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states.
Developing a State-based Quality Measurement Program Using an Episode-of-Care Framework: Recommendations for State Purchasers
Francois de Brantes, MS, MBA, Health Care Incentives Improvement Institute
In attempting to move toward value-based payments, there exist the inherent challenges posed by the availability of data. States wishing to accelerate the transformation of the existing delivery system into one that delivers high quality and affordable health care have to take action to develop a comprehensive data collection and reporting mechanism. Such an approach can be taken using episodes of medical care as the central unit of measure. This issue brief, prepared by the Health Care Incentives Improvement Institute, examines steps that state purchasers can take to develop a quality measurement program based on episodes of care, leveraging existing information technology infrastructure and clinical registries, offering specific suggestions for state purchasers.