Test 3 Star Measures and Payment Incentives Flashcards
1
Q
purpose of health care report cards
A
- Monitor performance
- Provide feedback
- Encourage competition between providers
- Set quality standards with benchmark metrics
- Identify and encourage best practices
2
Q
Impact of Report Cards
A
- Infrequently used
- Not consumer friendly
- Validity of reports are controversial
- Impact will grow as measures and reporting improve
3
Q
How does Medicare Star Rating system works?
A
Plans receive a summary rating, ratings on the four domains, and scores on 18 individual measures
4
Q
What does CMS rate Medicare plans on?
A
– Customer service
– Complaints & problems
– Member experiences
– Patient safety and drug pricing accuracy
5
Q
weight of pharmacy measures
A
- adherence (tripled measured); diabetes, HTN, cholesterol
- patient safety (tripled weighted); HRM, diabetes treatment
- MTM (single weighted)
6
Q
Potential Pitfalls of P4P
A
- Gaming the program
- Crowding out of intrinsic motivation
- Ignoring non-motivational factors
- Motivation improvement will not last
7
Q
RxSelect CPESN Core Services
A
– One-on-one Pharmacist Consultation – Immunization Screening and Administration – Adherence Support – Comprehensive Medication Review – Medication Reconciliation – Disease State Management
