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Comparative Study
. 2018 Dec;53(6):4477-4490.
doi: 10.1111/1475-6773.13031. Epub 2018 Aug 22.

Comparison of Approaches for Aggregating Quality Measures in Population-based Payment Models

Alex McDowell  1 , Christina A Nguyen  2 , Michael E Chernew  2 , Kevin N Tran  3 , J Michael McWilliams  2   4 , Bruce E Landon  2   5 , Mary Beth Landrum  2
Affiliations
Comparative Study

Comparison of Approaches for Aggregating Quality Measures in Population-based Payment Models

Alex McDowell et al. Health Serv Res. 2018 Dec.

Abstract

Objective: To assess the impact of alternative methods of aggregating individual quality measures on Accountable Care Organization (ACO) overall scores.

Data source: 2014 quality scores for Medicare ACOs.

Study design: We compare ACO overall scores derived using CMS' aggregation approach to those derived using alternative approaches to grouping and weighting measures.

Principal findings: Alternative grouping and weighting methods based on statistical criteria produced overall quality scores similar to those produced using CMS' approach (κ = 0.80 to 0.95). Scores derived from giving specific domains greater weight were less similar (κ = 0.51 to 0.93).

Conclusions: How measures are grouped into domains and how these domains are weighted to generate overall scores can have important implications for ACO's shared savings payments.

Keywords: Quality of care/patient safety (measurement); evaluation design and research; health care organizations and systems; health policy/politics/law/regulation; payment systems: FFS/capitation/RBRVS/DRGs/risk adjusted payments etc..

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Figures

Figure 1
Figure 1
(a) Scatterplot of 5 percent Difference in Overall Quality Score Calculated with Empirical versus CMS Domains, Equal Weights within and Across Domains. (b) Scatterplot of 10 percent Difference in Overall Quality Score Calculated with Empirical versus CMS Domains, Equal Weights within and Across Domains
See this image and copyright information in PMC

References

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