Accounting for Social Risk Factors in Medicare Payment

Accounting for Social Risk Factors in Medicare Payment

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2016-10-14

Total Pages: 83

ISBN-13: 0309448042

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Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver. Accounting For Social Risk Factors in Medicare Payment: Data is the fourth in a series of five brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report provides guidance on data sources for and strategies to collect data on indicators of social risk factors that could be accounted for Medicare quality measurement and payment programs.


Implementing High-Quality Primary Care

Implementing High-Quality Primary Care

Author: National Academies of Sciences, Engineering, and Medicine

Publisher:

Published: 2021-06-30

Total Pages: 448

ISBN-13: 9780309685108

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High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.


Federal Register, V. 69, No. 154, Book 1, Wednesday, August 11 2004

Federal Register, V. 69, No. 154, Book 1, Wednesday, August 11 2004

Author:

Publisher: National Archives and Records Administration

Published: 2004-08

Total Pages: 488

ISBN-13: 9780160723247

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Contains: Part 2, Department of Health and Human Services, Centers for Medicare & Medicaid Services, 42 CFR Parts 403, 412, et al., Medicare Program: Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2005 Rates; Final Rule. Also contains other proposed rules, new rules, and notices.