The pay-for-value movement could justify rewarding—and punishing—doctors based on quality scores. Problem: Hardly anyone likes the current ways quality is measured, especially physicians. Few believe that Medicare’s Merit-based Incentive Payment System (MIPS) will clear things up. In fact, it might cause more confusion.
And that means full scope of practice as primary care providers. Medical societies hate the idea and think that nurse practitioners need to be tethered securely to a physician office in order to ensure top-notch care. Nurse practitioners counter that they can help shore up primary care.
Patient-reported outcomes measures (PROMs) use a patient’s response to questions to measure health status. If they’re going to catch on payers will need to incentivize use. So far, that’s not happening. But clinicians who use PROMs for clinical decision making might be providing a valuable service.
Quality clinical practice for the management of diabetic patients should include screening for nephropathy. Reliance on a prescription alone should not be considered evidence of effective screening for such patients when that drug is used for other clinical indications.
Community Servings, a not-for-profit organization in the Boston area, delivers medically tailored meals that take into account the nutritional needs of people with chronic illnesses. The idea is to ensure that a patient’s food addresses his or her specific health conditions.