Maverick's Update

Even though it is very hot there, people in Los Angeles were able to focus on putting the great talents of Matthew Stafford and Cooper Kupp together. We should do that to solve our serious healthcare data problems. Over the past several months, great titans of the healthcare policy expert society have been duking it out in Health Affairs (this is the peer-reviewed, nonpartisan journal where health nerds play football) over how to fix the Medicare Advantage program — which is, ultimately, a data problem. Well-respected thought leaders, including but not limited to Rick Gilfillan, Don Berwick, Rick Kronick, George Halvorson, Don Crane, Michael Chernew, and David Lansky, have all weighed in on how to get more value out of our expensive healthcare system. There is much at play here, but we will boil down the arguments into one problem to solve: how proper risk adjustment requires better data. Basically, how can we more accurately determine how to match up sick people with the care they need, and incentivize the industry players to follow through? Luckily, CMS seems to agree that this is what we should be focused on. In its Advance Notice of Medicare Advantage policy changes, CMS asked for comments on how to enhance its risk adjustment model and develop new measures that demonstrate how MA plans are driving quality through value-based models with providers. Indeed, back in September 2021, CMS published this supplemental material to its Measures Management System Blueprint, explaining that there are limitations in data sources to achieve proper risk adjustment. If Snoop Dogg and Martha Stewart can get together for a Superbowl commercial — can’t we get our experts to come together to solve our healthcare data problems?