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Comparison of Approaches for Aggregating Quality Measures in Populationbased Payment Models

Objective: To assess the impact of alternative methods of aggregating individual quality measures on Accountable Care Organization (ACO) overall scores.

Data Source: 2014 quality scores for Medicare ACOs.

Study Design: We compare ACO overall scores derived using CMS’ aggregation approach to those derived using alternative approaches to grouping and weighting measures.

Principal Findings: Alternative grouping and weighting methods based on statistical criteria produced overall quality scores similar to those produced using CMS’ approach (κ = 0.80 to 0.95). Scores derived from giving specific domains greater weight were less similar (κ = 0.51 to 0.93).

Conclusions: How measures are grouped into domains and how these domains are weighted to generate overall scores can have important implications for ACO's shared savings payments.

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