Blog post
May 15, 2020 / By Richard Fuller, MS
In a prior blog, we highlighted the results of our research into patient outcomes, potentially preventable admissions (PPAs) and emergency room visits (PPVs)1among nursing home residents. In that research, we […]
Blog post
July 24, 2019 / By Richard Fuller, MS
Risk adjustment is a correction applied in hospital performance measurement to account for the contribution of population characteristics that are beyond the control of the hospital. The effects of these […]
Blog post
April 12, 2019 / By Richard Fuller, MS
One of the fundamental objectives of Medicaid programs contracting out their sizeable budgets to managed care companies is to improve the quality of care for their beneficiaries. As we frequently […]
Blog post
March 13, 2019 / By Richard Fuller, MS
Modern Healthcare recently published another article questioning the utility of the CMS hospital readmission reduction program (HRRP). The article used as its basis two publications, the first of which returned […]
Blog post
Oct. 10, 2018 / By Richard Fuller, MS
At the end of September, CMS posted the latest round of data supporting the Hospital Readmission Reduction Program. This is the first year of compliance with the direction of the […]
Blog post
Aug. 24, 2018 / By Richard Fuller, MS
June and July saw a flurry developments highlighting the challenges with the five star nursing home compare ranking system. In June, the Veterans Administration released their star rankings for VA […]
Blog post
June 11, 2018 / By Richard Fuller, MS
Viewing risk-adjustment as a process of balancing financial risk across defined patient cohorts, rather than the risk posed by an individual, is a position statement rather than an accepted norm. […]
Blog post
May 16, 2018 / By Richard Fuller, MS
Within the CMS proposed rule for FY2019 published at the end of April, there is a proposal to consolidate and improve the value-based purchasing (VBP) payment adjustment model. On the […]
Blog post
March 21, 2018 / By Richard Fuller, MS
In this blog, we return to how socioeconomic status is accounted for when measuring patient outcomes. We have actively participated in the debate on how to identify potentially preventable readmissions […]
Blog post
Nov. 1, 2017 / By Richard Averill, MS, Richard Fuller, MS
Would an Amazon-like price shopping experience for individual healthcare services help control healthcare costs? Price transparency is frequently cited as a possible strategy for reducing the cost of healthcare because […]
Blog post
Oct. 11, 2017 / By Richard Averill, MS, Richard Fuller, MS
Medicare beneficiaries are constantly bombarded with mail, emails and advertisements from insurers encouraging them to buy a Medicare supplemental insurance policy. It seems odd that there is such an aggressive […]
Blog post
Sept. 18, 2017 / By Richard Fuller, MS
In June the GAO released a report examining the Medicare Hospital Value Based Purchasing (HVBP) payment initiative. This is not their first look at HVBP, with a previous report from […]
Blog post
April 19, 2017 / By Richard Fuller, MS, Norbert Goldfield, MD
While Congress is finding it difficult to reach consensus on how to improve health care in the United States, the one thing we all can agree on is that ever-rising […]
Blog post
Jan. 23, 2017 / By Norbert Goldfield, MD, Richard Fuller, MS
Everyone, except for the measurement industry, seems to agree that we have too many metrics1 for measuring performance. An increasing number of individuals and organizations are also saying that the […]
Blog post
Dec. 19, 2016 / By Richard Fuller, MS, Norbert Goldfield, MD
In this month’s blog we return to a recurring theme—the issues related to risk adjustment and performance measurement. More specifically, we think it is important to take a closer look […]
Blog post
Nov. 18, 2016 / By Richard Fuller, MS, Norbert Goldfield, MD
In a recent perspective piece in JAMA Forum, Dr. Ashish Jha of the Harvard School of Public Health argues that increased provider consolidation is threatening the financial viability of the […]
Blog post
Oct. 21, 2016 / By Richard Fuller, MS, Norbert Goldfield, MD
The conservative columnist Charles Krauthammer opined in a recent Washington Post editorial: “The Democrats will eventually push to junk Obamacare for a full-fledged, government-run, single-payer system. Republicans will seek to […]
Blog post
Sept. 21, 2016 / By Norbert Goldfield, MD, Richard Fuller, MS
Last month, an article appeared in Modern Healthcare lauding the achievement of New York’s Bellevue Hospital in reducing readmissions to their facility. The article raised a number of issues relating […]
Blog post
Aug. 17, 2016 / By Richard Fuller, MS, Norbert Goldfield, MD
In the past few weeks, the Journal of the American Medical Association (JAMA) published an article and the National Academies of Sciences, Engineering and Medicine (the Academies) released a report […]
Blog post
July 20, 2016 / By Richard Fuller, MS, Norbert Goldfield, MD
In developing our classification tools we are continually called upon to make judgement calls on the relative clinical complexity of individuals and the interaction between comorbid chronic conditions on quality […]
Blog post
June 20, 2016 / By Norbert Goldfield, MD, Richard Fuller, MS
A recent article in the journal Medical Care examines the validity of AHRQ Patient Safety Indicators (PSIs) and CMS Hospital-acquired Conditions (HACs) given the growing reliance of these measures for […]
Blog post
May 18, 2016 / By Norbert Goldfield, MD, Richard Fuller, MS
In our March blog, we highlighted some of the challenges with the CMS Hospital Readmission Reduction Program (HRRP). In that blog, we alluded to similar design flaws that are present […]
Blog post
April 18, 2016 / By Richard Averill, MS, Richard Fuller, MS
Our recent article, “Implementing a Site-Neutral PPS,” published in the HFMA journal, highlights the potential for a reform currently making its way through the legislative process. The proposed legislation—referred to […]
Blog post
March 18, 2016 / By Richard Fuller, MS, Norbert Goldfield, MD
We have discussed payment adjustment for readmission measures in previous blogs. In those blogs, we focused upon risk-adjustment, preventability and the need to account for socioeconomic status (SES) when necessary […]
Blog post
Jan. 25, 2016 / By Richard Fuller, MS, Norbert Goldfield, MD
In this blog we take a look at risk-adjustment models used in population health. There are two related but distinct uses for population risk models – payment and population health […]
Blog post
Dec. 21, 2015 / By Norbert Goldfield, MD, Richard Fuller, MS
Health status can be defined succinctly as, “the range of manifestation of disease in a given patient including symptoms, functional limitation, and quality of life, in which quality of life […]
Blog post
Nov. 16, 2015 / By Richard Fuller, MS, Norbert Goldfield, MD
In the MedPAC October meeting, the commission returned to the seemingly intractable problem of equalizing access to health care for rural communities. Medicare payment offers three sources of support within […]
Blog post
Oct. 16, 2015 / By Norbert Goldfield, MD, Richard Fuller, MS
In a recent blog we made the case for quantifying the net effect of drugs upon health expenditures so as to make more rational decisions. Providing information about costs and […]
Blog post
Aug. 21, 2015 / By Norbert Goldfield, MD, Richard Fuller, MS
…for the engine to pick up steam. In the past ten years, the train carrying healthcare pricing and quality information has been rolling but the caboose is still waiting at […]
Blog post
July 22, 2015 / By Norbert Goldfield, MD, Richard Fuller, MS
This blog offers further commentary on the excellent conversation that Paul Levy began in his column, “The Triple Aimers have Missed the Mark.” In his blog, he provides a succinct […]
Blog post
June 26, 2015 / By Norbert Goldfield, MD, Richard Fuller, MS
For the last decade, we have been fortunate enough to work with many state Medicaid programs and commercial payers on reform efforts incorporating outcomes targets for health care providers. The […]
Blog post
May 18, 2015 / By Norbert Goldfield, MD, Richard Fuller, MS
We believe there are two core principles that should be adhered to when implementing payment reform initiatives. First, that measurement of performance change should be directly quantifiable in dollars where […]
Blog post
Jan. 19, 2015 / By Norbert Goldfield, MD, Richard Fuller, MS
It is well known that a viable source of health dollar savings is the efficient use of post-acute care (PAC) services. MedPAC has identified widespread variation in post-acute care utilization, […]
