Cheryl L. Damberg, PhD

This article examines how CMS’ adjustment for social risk factors affects the Medicare Advantage Star Ratings and the type of contracts affected by the adjustment.

Physician organizations are applying behavioral nudges to influence physician behavior; however, their use is limited to a narrow range of clinical applications.

Hospitals reported widespread adoption of quality improvement (QI) changes to improve on CMS quality measures, and QI adoption was associated with improved performance on quality measures.

Health systems are important in driving electronic health record adoption in ambulatory clinics, although the uptake of key functionalities varies across systems.

Use of clinical decision support (CDS) in ambulatory clinics is increasing but remains modest. The CDS function with the greatest use is basic medication screening, which increased from 52% of clinics nationally in 2014 to 61% in 2016.

In a survey of community health center medical directors in 9 Medicaid expansion states and DC, nearly 60% reported difficulty obtaining new specialist visits and multiple access barriers on behalf of their patients.

Value-based payment is promoting care delivery transformation among California physician organizations, although the initial focus has been on controlling hospital costs and redesigning primary care.

Disparities in care are a complex issue requiring multiple strategies to solve, including approaches to improve the measurement of quality and reporting stratified performance estimates.

CMS implemented the Categorical Adjustment Index as part of the Medicare Advantage and Part D Star Rating Program in 2017. These analyses informed its development. Check out our website’s new table/figure pop-up feature! Click on the name of a table or figure in the text to see it in your browser.

Nearly 40% of US ambulatory care practices are “under-users” of health information technology functionalities, which impacts the ability of the health system as a whole to provide coordinated, efficient care.

This study examines the clinical effects of care management and quality improvement interventions implemented by physician groups on pay-for-performance success.

The authors describe several simple changes that health plans can make in the design of pay-for-performance programs that may improve their effectiveness.