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Lack of Agreement on Measuring Quality, Efficiency
Medicare's new payment formula is set to begin in 2019. The problem is no one's agreed on standards for measuring quality or efficiency of patient care.
Until recently, the US government and insurance companies paid doctors for volume of services provided, rewarding them for needless treatments. Economists and policymakers have long called for flipping those incentives so physicians are paid for the quality, not quantity, of care they deliver. That goal is embedded in the Affordable Care Act, which penalizes hospitals when patients get readmitted. Paying for quality is an approach that private insurers, employers, and state Medicaid plans have adopted.
In April, President Obama signed a bipartisan Medicare reform bill that mandates linking doctor pay to performance. Under the new law, Medicare, which insures 54 million elderly and disabled Americans, will begin rating doctors on a scale from 0 to 100 based on factors such as quality and efficiency. Top-scoring physicians will eventually be paid at rates above standard Medicare fees, and laggards will face penalties.
Medicare’s new payment formula is set to begin in 2019. The problem is no one’s agreed on standards for measuring quality or efficiency of patient care.
Read more at Bloomberg: http://bloom.bg/1HcBLGI
Sustaining Compassionate Trauma Care Across Communities
September 30th 2024September is National Recovery Month, and we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In our final episode, we speak with Lyndra Bills, MD, and Shari Hutchison, MS.
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Despite Record ACA Enrollment, Report Reveals Underinsured Americans Are in Crisis
November 21st 2024Despite significant progress in expanding health insurance coverage since the Affordable Care Act (ACA) was enacted, millions of Americans still face critical gaps in access to and affordability of health care.
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New Study Finds Risk Groups, Outpatient Care Barriers in Chronic Liver Disease
November 20th 2024Patients with chronic liver disease who were unable to establish care were 85% more likely to require recurrent hospitalizations. This group included a disproportionate number of women and individuals with physical limitations affecting their health.
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