SNP Policy Reports

QUALITY MEASURES NEED ADJUSTMENT

March 31, 2015 - Inovalon

With input from The SNP Alliance, Inovalon conducted a study of CMS Star Measures, comparing unadjusted results of dual eligible to non-dual beneficiaries enrolled in the same health plan. Their "An Investigation of Medicare Advantage Dual Eligibles Member-Level Performance on the Centers for Medicare and Medicaid Services (CMS) Five-Star Quality Measures," found that beneficiary income and other sociodemographic factors were strongly associated with adverse health outcomes. The findings support other evidence that factors and characteristics outside of the health plan and providers control affect outcomes and that plans that specialize in serving these vulnerable populations may be penalized in the quality measurement system.

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THE SNP ALLIANCE REPORTS

SNP Alliance Gold Standards Framework
Gold Standards Executive Summary
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OTHER EXTERNAL AGENCY REPORTS

CMS

Blueprint for the CMS Measures Management System, Version. 12.0 May 2016


National Quality Forum

Advancing Person-Centered Care for Dual Eligible Beneficiaries through Performance Measurement, Final Report, August 31, 2015

MedPAC

Medicare Advantage Program: Status Report
; Chapter 12 in MedPACs March 2016 Report to Congress

Institute of Medicine

Accounting for Social Risk Factors in Medicare Payment: Identifying Social Risk Factors January 2016 [Abstract]

RTI International

Medicare/Medicaid Enrollees: Preliminary Findings from the Washington MFFS Demonstration, January 4, 2016

Report on the Early Implementation of Demonstrations under the Financial Alignment Initiative, October 15, 2015