This report proposes alternative methodologies for determining the practice expense (PE) component of the Medicare Physician Fee Schedule in order to avoid misvalued payment rates. A main concern is the allocation of indirect practice costs.
High quality care for seriously ill patients could be promoted by developing a nationally endorsed survey instrument that assesses patient and family experiences of serious illness care, an administrative data structure to identify the most knowledgeable respondents for the survey, and a tool kit of quality improvement approaches.
Risk-reduction strategies adopted by Medicare Advantage plans to prevent hospital readmissions have not succeeded in lowering the markedly higher rates of readmission for black patients compared to white patients.
Quality measures and payment approaches for community-based programs serving seriously ill patients should incorporate core components such as communication, shared decision making, and advance care planning.
The Medicare Access and Chip Reauthorization Act (MACRA) will decrease Medicare spending on physician services by an estimated -$35 to -$106 billion and change spending on hospital services by +$32 to -$250 billion between 2015 and 2030.
In this March 2017 congressional briefing, RAND senior economist, Christine Eibner, discusses how individuals and employers will respond to major health care policy changes as the new administration reassesses the Affordable Care Act.
This report summarizes RAND's pilot testing of a set of proposed nonpayment codes that physicians would use for post-operative visits. The goal of testing was to assess whether practitioners understood and could correctly apply the codes.
Starting in 2019, the Medicare Access and CHIP Reauthorization Act will integrate and potentially simplify performance measurement by combining many measures and programs. Research provides insight into how to avoid pitfalls in MACRA's rollout.
To inform the debate in the New Jersey state legislature, this report analyzes the role of payments for involuntary out-of-network care for New Jersey hospitals' financial performance and simulates the effect of policies to limit such payments.