Tag Archives: CMS

Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits

By | November 8, 2024

*This post was originally published on KFF Health News on November 8, 2025. It is published with open permission by that site. A new federal watchdog audit is ratcheting up pressure on government officials to crack down on billions of dollars in overcharges linked to Medicare Advantage home visits. But so far, the Centers for Medicare & Medicaid… Read More »

Downstream Efforts to Address Social Determinants in the CMS Financial Alignment Initiative

In our last blog post, we discussed the Biden Administration’s infrastructure package as an example of an upstream policy effort that could promote equity and help address disparities. However, as we pointed out in the first in this series of blogs, stakeholders who interact with community members are best suited to identify social risk factors… Read More »

Potential effects of COVID-19 on health care utilization and quality measures

What are the potential impacts of COVID-19 on health care utilization? How will changes in healthcare use impact quality measures? Researchers are asking many key questions to understand the impacts of COVID-19. It is clear that trends in healthcare use are changing. These changes will likely affect quality measure scores in the future. This is… Read More »

Timing is Everything: Defining the Serious Illness Population for Palliative Care

The current healthcare system is not built for individuals with serious illnesses. These individuals can benefit from palliative care, which focuses on quality of life and symptom relief. Alternative payment models that incorporate palliative care are in development. Yet, the challenges of expanding these models of care are substantial. Betsy recently died after a sixteen-year… Read More »

The ICD-10 transition changed the game more than you think

By | July 25, 2019

The codes of the International Classification of Diseases (ICD) serve as the backbone for billing, payment, and surveillance programs across the entire healthcare system – nationally and globally. Recent research published in Medical Care by Alexander Mainor and colleagues from the Dartmouth Institute for Health Policy & Clinical Practice has shown that the transition of… Read More »

One Step Ahead: A Composite Measure to Capture Critical Hospice and Palliative Care Processes

The Centers for Medicare and Medicaid Services (CMS) wants to empower consumers to make informed healthcare decisions. CMS also wants providers to improve the quality of care they provide. One step towards accomplishing both of these goals is by public reporting of quality measures (QM). However, with multiple quality measures focusing on different care processes–all of which… Read More »