CMS wants you to be able to use a standard set of quality measures for the myriad value-based care contracts you might be involved in. Dubbed the Universal Foundation, these measures are set to streamline quality reporting in different contracts. The most exciting part? They include social determinants of health screening and the ability to quantify health disparities. [Patient EngagementHIT] 

The agency outlined the Universal Foundation in a February 1 article in the New England Journal of Medicine, explaining that in their 20-year history, quality measures have become more complex, redundant, and in some cases meaningless to improving clinical quality. Although integral to moving value-based care forward, quality measures can be a headache for many in the healthcare industry.

“Since there is tension between measuring all important aspects of quality and reducing measure proliferation, we are proposing a move toward a building-block approach: a ‘universal foundation’ of quality measures that will apply to as many CMS quality-rating and value-based care programs as possible, with additional measures added on, depending on the population or setting,” CMS leadership wrote in the NEJM article.

The proposed Universal Measures include 23 measures ranging from preventive care and screenings, behavioral health, and chronic disease management. These measures, which CMS has made room to iterate in the future, would start as a baseline and some programs might require supplemental measures. The agency emphasized that additional measures would go under strict scrutiny before being added to program requirements.

To much celebration from Gary Price, MD, the CEO of the Physician’s Foundation, the measures also include two that look at the social drivers of health.

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GETTING IT RIGHT ON QUALITY MEASURES

In some ways, the Universal Foundation is a CMS effort to course correct on quality measures. Quality measures are instrumental to any quality improvement program, including certain value-based care programs. As the old adage goes, you cannot improve what you do not measure.

But as both CMS and Price indicated, those quality measures had become overly complex. Different programs might measure different outcomes, or they might be looking at the same outcome but use different language when detailing the measure.

“One of the problems with the quality measures up to this point is that they often weren't aligned with each other either within the coding system itself or between hospitals and physicians or even between different insurers and the way they're coded,” Price explained. “That's become kind of a mess, and I think CMS has signaled that they want to help improve that.”

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 The medical industry is far from achieving racial health equity, according to a new report from Accenture. But it could be. [Patient Engagement Hit] 

...In an analysis of peer-reviewed research and expert commentary, the researchers outlined the five interconnected barriers blocking health equity from coming to light: implicit bias, lack of trust and fear, access barriers, uneven quality and experience, and racism in research and development or clinical practices.

Barriers to Achieving Racial Health Equity 

• Implicit bias
• Patient Trust 
• Care Access Barriers
• Unequal quality 
• Patient Experience 
• Racism

The report, which outlines some of the stark racial health disparities still plaguing the US, also looks at the barriers keeping the nation from confronting its problems and a roadmap for mitigating these issues.

Looking at race, specifically, because it is the most prominent predictor of health inequity, the researchers noted that outcomes still aren’t equitable for all. There are 3,400 more infant mortalities among Black babies than White, the report authors said, and an additional 9,200 Black cancer deaths each year, too.

Full article here> 

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Questions Remain About What SARS-CoV-2 Variants Should Go Into the Annual COVID-19 Vaccines Proposed by the FDA | FDA proposes one single vaccine per year. [JAMA]

From the beginning, a scorecard might have come in handy for keeping track of the whos, whats, and whens of COVID-19 vaccination.

...Three years into the COVID-19 pandemic and more than 2 years since vaccines became available, however, the US Food and Drug Administration (FDA) wants to get down to 1 vaccine dose per year for most people, following an annual review of the circulating SARS-CoV-2 variants du jour to determine the shot’s optimal makeup.
Under the FDA’s proposed plan, everyone’s annual vaccine,
administered in the fall, would be composed of the same variant or variants, no matter whether it’s their 1st or 5th or 15th dose. (“I think this virus is going to be with us forever,” vaccine expert Paul Offit, MD, said in an interview.)

Download PDF here> 

Full article here> 

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Race-based medicine in the US, which has unjustly contributed to racial inequities in clinical care and health outcomes, has reinforced well-documented mistrust toward the health care enterprise.¹ The urgency of abolishing race-based medical practices, including the use of algorithms informing risk stratification, diagnosis, and treatment approaches, has fueled national efforts to identify and reform these practices.² The recent US Organ Procurement and Transplantation Network (OPTN) decision to modify kidney transplant wait times for Black individuals affected by race-based kidney function estimating equations provides an exemplar of how a focus on justice, reform, and repair can advance our efforts to pursue equity.

Download PDF of full article here>

Full article here> 

Video - You may be interested in viewing the IOMC video " Systemic Issues Impacting Kidney Disease and Equity" here. 

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No-barrier mental health care services in Austin are available through six organizations partnering with the Chicago Department of Public Health in a major push to expand mental health services to all 77 of Chicago’s neighborhoods that was announced earlier this month. [Austin Talks]

Six organizations operating in Austin – Bobby E. Wright Comprehensive Behavioral Health Center, BUILD Chicago, Community Counseling Centers of Chicago, Habilitative Systems Inc., Infant Welfare Society and PCC Community Wellness Center – are part of a citywide network known as Chicago’s Trauma-Informed Centers of Care (TICC).

These clinics and nonprofits offer Austin residents key services like therapy and trauma recovery, clinical care, behavioral health and substance use treatment. Some of these organizations offer crisis intervention services for families, support services for people dealing with substance use and mental health services for young people.

In a recent press release, Mayor Lori Lightfoot announced the city is expanding mental healthcare access for Chicago residents through partnerships with community-based organizations and clinics. Activists have long called for the city to improve access to healthcare services after the closure of 12 city-run clinics during Mayor Rahm Emanuel’s administration.

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About six in 10 U.S. adults said they would feel uncomfortable if their provider used artificial intelligence tools to diagnose them and recommend treatments in a care setting, according to a survey from the Pew Research Center. [Healthcare Dive]

Some 38% of respondents said using AI in healthcare settings would lead to better health outcomes while 33% said it would make them worse, and 27% said it wouldn’t make much of a difference, the survey found.

Ultimately, men, younger people and those with higher education levels were the most open to their providers using AI.

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A House committee approved a plan Wednesday morning to clarify what nursing homes meet a “distressed facility” designation. [Health News Illinois]  The legislation, sponsored by Rep. Anna Moeller, D-Elgin, comes as the designation has been in place for several years, but has never been implemented due to outdated language. Exact language for the new criteria is being drafted, with the hope an amendment will address concerns raised by stakeholders, Moeller told the House’s Human Services Committee. Allison Nickrent, division chief of governmental affairs for the Department of Public Health, said they hope to "give each of these distressed facilities the attention that they need.” Unlike current facility inspections, the designation would allow the agency to create a program for owners of the facilities to help implement an improvement plan. Penalties could increase as well. The criteria would also include a process to allow a facility to appeal the calculation that put them on the list or to be removed from it. Ron Nunziato, senior director of policy and regulatory affairs at the Health Care Council of Illinois, said they oppose penalizing the state’s most distressed facilities. Instead, he suggested helping IDPH work with distressed facilities on their challenges or improve the time between the agency’s revisits. “I want to be clear, governments can't be successful in changing the paradigm of these facilities — the most challenging facilities of this day — by penalizing them,” Nunziato said. Additionally, he worried about possible confusion if nursing homes end up with the state designation and the Centers for Medicare and Medicaid Services’ “special focus facility” program to improve a location's quality of care. Matt Hartman, executive director of the Illinois Health Care Association, said while they filed neutral on the language, they're “borderline supportive” of the bill. They want to see the additional framework focus more on resident care outcomes and things that drive quality in the sector. “We've already shared language and we think this is something that should be done,” Hartman said. ###

Thirty-nine grants totaling $25 million will head out to Cook County organizations to expand anti-violence programming in vulnerable communities, local and state agencies announced Tuesday. [Health News Illinois]

The funds, a partnership between the Department of Human Services’ Office of Firearm Violence Prevention and Cook County’s Justice Advisory Council, will support 74 groups focused on supporting residents at high risk of experiencing gun violence as either a victim or a perpetrator.

"This funding demonstrates a commitment among Illinois leaders to cooperate and eliminate bureaucratic hurdles so that qualified violence prevention providers can quickly receive the resources that they need to adequately address firearm violence, one of our state's most significant public health challenges," Chris Patterson, DHS’ assistant secretary, said in a statement.

The announcement builds on $75 million in grants issued last year by the council to address the issue. 

 See the full list of recipients here.

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One in seven in-hospital delivery stays for non-Hispanic White women included a diagnosis of a mental health disorder in 2020 (14 per 100 delivery stays), the highest rate among any race/ethnicity group. In-hospital delivery stays for Asian/Pacific Islander women included the lowest diagnosis rate, at just 3.6 per every 100 stays (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #302,

Highlights: 

• In 2020, White non-Hispanic women had the highest rate of delivery stays involving mental health disorders (14.0 per 100 delivery stays), and Asian/Pacific Islander non-Hispanic women had the lowest (3.6 per 100 delivery stays).
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• Between 2017 and 2020, the rate of delivery stays involving mental health disorders increased 52 percent, with the lowest rate of increase among Black non-Hispanic women (47 percent) and the highest rate of increase among other non-Hispanic race/ethnicity women (71 percent).
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• Anxiety and obsessive-compulsive disorders were the most common type of mental health disorder among delivery stays in 2020, with the highest rate among White non-Hispanic women and the lowest rate among Asian/Pacific Islander non-Hispanic women (9.6 and 2.2 per 100 delivery stays, respectively).
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• The rate of delivery stays involving anxiety and obsessive-compulsive disorders increased 74 percent between 2017 and 2020.
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• Select obstetric risk factors were more common among delivery stays involving at least one mental health disorder than among delivery stays with no mental health disorders (79.1 vs. 62.5 per 100 delivery stays, respectively).

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Millions of Americans mired in medical debt face difficult financial decisions every day — pay the debt or pay for rent, utilities and groceries. Some may even skip necessary health care for fear of sinking deeper into debt. [Modern Healthcare]

To address the problem, an increasing number of municipal, county and state governments are devising plans to spend federal coronavirus pandemic relief funds to eliminate residents' medical debt and ease those debt burdens.

Related: 18% drop since 2020 in people with reported medical debt

... Cook County, Illinois, which includes Chicago, and Pittsburgh, New Orleans and Toledo, Ohio, are among more than a dozen communities that have set into motion or are considering similar plans. Democratic Connecticut governor Ned Lamont last week proposed spending $20 million in ARPA funds to eliminate as much as $2 billion in state residents' medical debts.

Unlike credit card or loan debt, medical debt is not a choice, advocates said.

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