CMS’ latest Physician Fee Schedule (PFS) proposed rule includes a health equity adjustment to quality performance, suggesting the federal agency recognizes inequities exist among ACOs serving safety-net populations, but is it the right approach?

In July 2021, California Governor Gavin Newsom signed into law AB 133, which calls for the development and implementation of a statewide Health and Human Services Data Exchange Framework — consisting of a data sharing agreement, policies, and procedures — to govern the exchange of health information among health care entities and government agencies by January 31, 2024.

By Trish Violett, Junior Policy Consultant and Megan Thomas, Director, Quality Initiatives

Over the past four years, the 52 hospitals and health systems participating in the California Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program have been working to improve care delivery and maximize health care value through a “pay-for-performance” model. The PRIME hospitals are using evidence-based quality improvement methods to achieve designated goals and outcomes on select clinical projects and associated performance metrics.