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.
This expert perspective reviews key considerations for states exploring Marketplace insurance subsidies and highlights the experiences in the five states that have established state-based subsidies that supplement the ACA’s premium tax credit and cost-sharing reductions.
The United States is in the midst of an unprecedented national effort to manufacture, distribute, and ultimately administer COVID-19 vaccines to all Americans. While the federal government is coordinating distribution of vaccines from manufacturers to states, individual states (and certain municipalities) are responsible for coordinating the various components of infrastructure and operational logistics needed to take the vaccine from federal distribution channels to the arms of Americans. This expert perspective outlines four recommendations for states to engage their managed care plans to assist in efforts to successfully and rapidly vaccinate the Medicaid population.