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Quality Metrics & Performance

Expert articles and analysis related to quality metrics & performance.

196 articlesLast 7 Days

AI Summary — Last 7 Days

CMS quality and payment policy is moving toward tighter accountability: Premier and HCTTF are pressing CMS on the CY 2027 PFS/MSSP rule to strengthen ACO participation, primary care investment, interoperability, and burden reduction while preserving outcome accountability, signaling that provider coalitions want VBC growth but with more workable performance infrastructure (Premier comments). At the same time, Medicare Advantage plans face a tougher Stars environment after CMS draft 2027 cutpoints made roughly half of rating thresholds harder to reach, increasing pressure on plans and delegated provider groups to improve measure execution, member experience, and risk-quality alignment (Healthcare Dive). The week’s broader pattern is a sharper divide between VBC models that can demonstrate measurable quality/cost impact and those that cannot, with scrutiny of virtual CKD management outcomes, MIPS’ decade-long payment-adjustment record, and payer prior authorization rollbacks all feeding executive focus on evidence, administrative simplification, and sustainable performance economics.

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