In our ongoing work to support payment reform initiatives to improve quality outcomes, The New Jersey Health Care Quality Institute has partnered with Catalyst for Payment Reform (CPR) to create Scorecards that address the question:

Are new payment models having their desired impact on health care costs and outcomes?

You can find out more in CPR’s short interview with Linda Schwimmer, the Quality Institute’s President and CEO by listening here.

In the last three years, CPR has issued several state and national Scorecards that collected, analyzed and categorized data to show how some health plans are paying health care providers, including which payment methods are being used, and how many dollars are flowing through each. In this next iteration, Scorecard 2.0, the reports will link payment reform to patient outcomes in the health care system. Working with respected leaders in their Advisory Group, CPR has identified 12 quality metrics to overlay on the original payment data.

Economic Signal Domain:

  • Patients seeking services from high-value providers through benefit and/or network design

System Transformation Domain: 

  • Physician participation in vertically integrated organizations that accept risk
  • Comprehensive diabetes care
  • HbA1c testing (NQF #057)
  • Cesarean section among women with low risk pregnancies
  • Forgone medical care

Outcomes Domain:

  • Childhood immunizations of seven vaccines
  • Controlling high blood pressure
  • Diabetes: Hemoglobin A1c poor control
  • Preventable hospital admissions (prevention quality indicator 90)
  • Pressure ulcer rate (patient safety indicator 03)
  • Patient reported information about recovery at home (CAHPS)
  • Patient reported information about quality of life (report fair/poor health or activity limitations because of physical, mental, or emotional problems)

The reports will include both quantitative analysis, using data provided by health plans in New Jersey, and qualitative findings, informed by interviews of health care leaders in the state. Two reports will be issued: one focusing on the Medicaid market and the other on the commercial market. The Quality Institute and Catalyst for Payment Reform expects to release these reports in the Fall of 2018. Check back here for an update.