Quality Metrics & Performance
Expert articles and analysis related to quality metrics & performance.
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CMS is signaling a harder turn toward measurable performance and provider accountability: the proposed mandatory, nationwide CJR-X model would put most hospitals at financial risk for joint-replacement episodes—including post-acute coordination with home health—while the ACCESS model ties voluntary participation to chronic disease outcomes supported by technology partners across obesity, diabetes, musculoskeletal pain, and depression. These moves suggest CMMI is pairing broader mandatory episode-based payment with “leaner” tech-enabled chronic care models, raising the bar for hospitals, ACOs, and vendors to prove outcomes, manage total cost, and operationalize quality metrics rather than simply participate in VBC contracts. Longer term, the emerging LEAD model concept points toward more durable Medicare accountable care architecture—locked-in benchmarks, expanded capitation, and specialist risk-sharing—intensifying strategic pressure on ACOs to build actuarial, specialty-management, and care-management capabilities ahead of a more risk-bearing decade (CJR-X proposal coverage; LEAD model analysis).
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