Milestone: Establish or join a public/private effort to compare performance on delivery system improvement with selected benchmarks
Public/private partnerships offer a vehicle to identify shared goals and measure performance across sectors. Shared goals and measures allow coordinated action to foster improvement—enabling the sectors to make more progress together than either could alone.
*Full name: Establish or participate in an existing public/private effort to compare state performance on delivery system improvement priorities to selected benchmarks.
*Relevance to the ACA:
Public/private partnerships to advance systems performance can maximize resources for data collection and sharing. Although the ACA does not require states to join or form partnerships it does provide private sector plans and providers with incentives to improve data collection and performance that could increase their interest in partnerships. For example,
Many providers will be developing methods for data collection in order to be eligible for the following incentives established by the ACA:
§3001 - Value-based incentive payments for hospitals that meet HHS performance standards for Medicare.
§3002 - Incentive payments for physicians who report quality data to Medicare.
§3007 - Adjusts Medicare physician payments based on the quality and cost of care that the physician delivers.
Private health plans will also analyze systems performance to adhere to HHS quality regulations and engage in Exchanges:
§1001 – Requires commercial insurance plans to report performance on quality measures to HHS and for HHS to make that information available to the public.
§1311 – Requires that commercial insurance plans report on quality measures as plan certification criteria for the Exchange.less