• Center on Health Equity & Access
  • Clinical
  • Health Care Cost
  • Health Care Delivery
  • Insurance
  • Policy
  • Technology
  • Value-Based Care

Lack of Agreement on Measuring Quality, Efficiency

Article

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

Related Videos
Rachel Rohaidy, MD
Tiffany Meng, PharmD, oncology pharmacist, UCSF Health
Screenshot of an interview with Shaun McKenzie, MD
Jeffrey Stark, MD, vice president and head of medical immunology at UCB.
Sabarish Ayyappan, MD
Dr Maria DeYoreo
Jade E. Jones, MD
Sabarish Ayyappan, MD
Gladys Antelo Allen
Debra Patt, MD, PhD, MBA, MPH
Related Content
© 2025 MJH Life Sciences
AJMC®
All rights reserved.