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CMS and Health Plans Announce Seven Sets of Quality Measures, Including Orthopaedics; Goal Is to Create Harmony

March 3, 2016

The Centers for Medicare and Medicaid Services (CMS) and America’s Health Insurance Plans (AHIP), which represents most commercial health insurance plans, released seven sets of clinical quality measures that cover areas such as accountable care organizations, patient-centered medical homes, cardiology, gastroenterology, and orthopaedics.

The goal is to reduce inefficiencies by putting the health plans and Medicare on the same page regarding some reporting measures.

Click here to read coverage from AHIP.

Click here to read coverage from CMS.

Some of the measures include:

  • Hospital-level risk-standardized complication rate following elective primary total hip or total knee arthroplasty (THA/TKA).
  • Hospital-level 30-day, all-cause risk-standardized readmission rate following elective THA/TKA.
  • Patient experience with surgical care based on the Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey.
  • Use of imaging studies for low-back pain.

Click here to learn more about the core measures.