CMS Circular 64 of 2017: Minimum data specifications with regard to Epilepsy and Parkinson Disease.The Managed Task Team 1, one of the task teams of the Industry Technical Advisory Panel (ITAP), has recently completed a project that focused on developing measures for the measurement of the quality, outcomes, and ultimately the value proposition of managed care interventions. The initiative is focused on the impact of managed care insofar as the techniques relating to funding of benefits for medical schemes beneficiaries are concerned.
Managed care organisations are required to demonstrate their value proposition as it relates to the manner in which they render managed care services to beneficiaries of medical schemes. The introduction of entry level criteria, process indicators and clinical outcomes measures for chronic disease conditions will enable the Council for Medical Schemes (CMS) to assess, guide, monitor and promote the measuring of value of managed care interventions offered to beneficiaries. Medical schemes will similarly be required to report forthwith on these process indicators and outcomes achieved in the Annual Statutory Returns (ASR).