Health Payer Intelligence December 28, 2017
The use of process and outcome measures allows payers analyze care quality and support population health initiatives.
Payers rely on process and outcome quality measures to communicate healthcare performance to new and current beneficiaries.
Quality measurements such as HEDIS, CMS Star Ratings, and standardized core quality measures (CQMs) are some of the tools used to develop objective comparisons between payers. Quality measurement sets also help develop high-value healthcare because they can provide a snapshot of how well clinical services are being performed and if services are cost-effective for beneficiaries.
Process and outcomes measures reveal if beneficiaries are receiving recommended preventive care and treatments, and if services rendered led to positive health outcomes.
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