CMSA Today - Issue 3, 2013 - (Page 12)

Outcome Reporting Moving Toward Meaningful Outcome Reporting W BY GARRY CARNEAL, JD, MA ith the Patient Protection and Affordable Care Act (PPACA) in full swing, case management interventions continue to take on a central role in the nation’s strategy to promote clinical and financial outcomes. In fact, “chronic disease management” is one of the 10 essential health benefits that all health plans will be required to offer under PPACA. This underscores the importance of such organizations as the Case Management Society of America (CMSA) and its mission – to provide professional collaboration across the health care continuum and advocate for patients’ well-being and improved health outcomes. and implementing program-specific measures. Understanding how to develop, implement, and improve program evaluation techniques to measure and report outcomes must be an important goal for all health care professionals, payers, and other stakeholders. An important dynamic to consider is the expansion of the “comparative effectiveness” movement in health care, which supports transparency and accountability in how clinical interventions – including case management programs – are measured for their true effectiveness. This movement also assesses the equivalency PROMOTING TRANSPARENCY & ACCOUNTABILITY of one intervention or program with another, which includes utilizing more direct outcomes measures such as NCQA’s HEDIS initiatives, various “Pay for Performance” programs, and Medicare’s Five-Star Quality Rating System, among others. Another crucial element of the new health care movement is utilizing The Patient-Centered Outcomes Research Institute (PCORI), a new organization authorized under PPACA, was formed to conduct research that promotes a public policy dialogue about the best ways to help patients and their health care providers make Understanding how to develop, implement, and improve program evaluation techniques to measure and report outcomes must be an important goal for all health care professionals, payers, and other stakeholders. 12 CMSA TODAY Issue 3 • 2013 • DIGITAL http://www.naylornetwork.com/cms-nxt/

Table of Contents for the Digital Edition of CMSA Today - Issue 3, 2013

President's Letter
Public Policy Committee
Are You Just a Care Coordinator?
Moving Toward Meaningful Outcome Reporting
Lost in Translation
Association News
Index of Advertisers
CMSA Corporate Partners

CMSA Today - Issue 3, 2013

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