Quality Metrics & Performance
Expert articles and analysis related to quality metrics & performance.
AI Summary — Last 7 Days
Medicare quality measurement is under pressure on two fronts: MA Star Ratings are facing escalating litigation and fiscal scrutiny after CMS’s post-Clover recalculations triggered Elevance’s $115 million challenge, while KFF estimates the MA Quality Bonus Program will still exceed $13 billion in 2026 despite fewer enrollees in bonus-eligible plans (KFF analysis). In parallel, Congress moved to ease Medicare ACO quality reporting requirements, signaling bipartisan appetite to reduce measurement burden even as CMS under the Trump administration weighs how to preserve accountability across ACOs, MA, and emerging specialty models (MedPage Today). For VBC leaders, the week’s pattern is clear: quality programs remain
Related Articles
Medicare Will Spend More Than $13 Billion on the Medicare Advantage Quality Bonus Program in 2026
The Medicare program will spend at least $13 billion on the Medicare Advantage quality bonus program in 2026, as 68% of Medicare Advantage enrollees are in a plan that qualifies for higher payments un...
Post-Clover and 2027 QBP Re-Calculation: What Could Be Next for MA Stars?
Overwhelmed ACOs: House aims to simplify quality reporting requirements
House Passes Bill to Ease Quality Reporting Requirements for Medicare ACOs
House Passes Bill to Ease Quality Reporting Requirements for Medicare ACOs MedPage Today
House Passes Bill to Ease Medicare ACO Digital Quality Reporting Burden
House Passes Bill to Ease Medicare ACO Digital Quality Reporting Burden AJMC
House Passes Bill to Ease Medicare ACO Digital Quality Reporting Burden
Best Practices for HEDIS in Behavioral Health
Best Practices for HEDIS in Behavioral Health AAPC
Pyx Health Uses Food-Based Engagement To Drive Quality Metrics And Deepen Payer Ties
Pyx Health Uses Food-Based Engagement To Drive Quality Metrics And Deepen Payer Ties TipRanks
Rethinking Coding and Documentation in a Value-Based Care Environment
How Shared Learning Helped Reduce Delivery-Visit Mortality by 41 Percent
Successful collaboratives combine data, performance benchmarking, peer learning and accountability to help organizations implement proven practices, reduce variation and drive measurable outcomes.