What to know
Quality measures are standards for measuring the performance and improvement of population health and delivery of health care services. Quality measures are increasingly used to determine payments to health care providers. DSMES is relevant to many important quality measures.
Common quality measures
Improving health and quality of care for all people is at the forefront of health care. One way to demonstrate this goal is with a common set of quality measures. These national quality measures are increasingly used to determine payment to hospitals, physicians, and other health care providers.
Some of the most common quality data measurement sets include:
Healthcare Effectiveness Data and Information Set (HEDIS)
Medicaid Adult Health Care Quality Measures
2021 Core Set of Adult Health Care Quality Measures for Medicaid (Adult Core Set)
Medicare Five-Star Quality Rating System
Partnership for Quality Measurement
Merit-Based Incentive Payment System (MIPS)
Medicare Shared Savings Program
Accountable Care Organizations and patient-centered medical homes are two models of coordinated care that aim to lower costs and improve quality.
DSMES may help meet quality measures
Demonstrating how a DSMES service addresses the quality measures PCMHs and ACOs must meet is one way to show the value of that service.
ACOs must meet and report on data that are used to calculate and assess their quality performance in four domains:
- Patient/caregiver experience
- Care coordination/patient safety
- Preventive health and screening
- At-risk populations
DSMES service staff should ensure that PCMHs and ACOs are aware of the DSMES service outcomes recommended in the 2022 National Standards for DSMES that are tracked, monitored, and reported, including:
- Knowledge
- Behavior change
- Clinical change
- Quality of life
- Satisfaction