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Health Care Payment Approaches

Report

Measuring Success in Health Care Value-Based Purchasing Programs: Summary and Recommendations

Reviews what has been learned over the past decade about performance-based payment strategies in health care and offers recommendations for the design, implementation, and monitoring and evaluation of value-based purchasing programs.

Mar 4, 2014
Report

Promise of Value-Based Purchasing in Health Care Remains to Be Demonstrated

After a decade of experimentation with reforms that give health providers financial incentives to improve performance, relatively little is known about how to best execute such strategies or judge their success.

Mar 4, 2014
Journal Article

Beyond Black and White: Race/Ethnicity and Health Status Among Older Adults

This study examined physical and mental health, health symptoms, sensory and functional limitations, risk factors, and multimorbidity among older Medicare managed care members to assess disparities associated with race/ethnicity.

Mar 1, 2014
Journal Article

Effects of Medicare Payment Reform: Evidence from the Home Health Interim and Prospective Payment Systems

Medicare continues to implement payment reforms that shift reimbursement from fee-for-service toward episode-based payment, affecting average and marginal payment.

Jan 21, 2014
News Release

Factors Linked to Creation of Accountable Care Organizations Identified

Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations, medical practice structures intended to improve medical care and cut costs.

Oct 7, 2013
Journal Article

Factors Linked to Creation of Accountable Care Organizations Identified

Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations, medical practice structures intended to improve medical care and cut costs.

Oct 1, 2013
Journal Article

Review of Experiences in Three Countries Informs England's Patient Choice Scheme

The experiences of Finland, Norway, and Sweden in offering patient choice schemes highlight England's need to carefully monitor the impact of enhanced choice in primary care to ensure that related policies truly enhance access to and improve the quality of care, and not inadvertently benefit those who are more able to exercise choice.

Sep 1, 2013
Journal Article

Does the Racial/Ethnic Composition of Medicare Advantage Plans Reflect Their Areas of Operation?

Investigating if the racial/ethnic composition of Medicare Advantage plans reflect the composition of their areas of operation revealed little evidence that health plans are selectively underenrolling blacks, Latinos, or Asians to a substantial degree.

Aug 28, 2013
Testimony

Designing a Performance-Based Incentive Program for Physicians

Value-based payment programs may encourage providers to innovate and redesign care delivery, potentially driving improvements in quality and efficiency.

Jul 12, 2013
Testimony

Improving Care for Medicare Beneficiaries with Physician Payment Reform

Physician payment policy is shifting from one that incentivizes the delivery of more services without regard to quality or outcomes to one that incentivizes the delivery of high quality, resource conscious health care. Thoughtful incentive design can ease the transition process for both physicians and the Medicare program.

Jun 5, 2013
Testimony

Efforts to Reform Physician Payment by Tying Payment to Performance

Public and private sector purchasers are actively working to design value-based payment programs to achieve the goals of improved quality and more efficient use of health care resources. How these programs are designed is a complex undertaking and one that will determine the likelihood of their success.

Feb 14, 2013
Journal Article

Care Experiences of Managed Care Medicare Enrollees Near the End of Life

Research based primarily on reports from an individual's surviving relatives often suggests that end-of-life care experiences are particularly poor. However, this examination of reports from patients found that those who died within a year of being surveyed reported slightly better experiences than other enrollees.

Feb 4, 2013
Journal Article

Should Payment Policy Be Changed to Allow a Wider Range of EMS Transport Options?

In light of growing concerns about the high cost of emergency care and heavy use of EDs, assessing EMS transport options should be a high-priority topic for outcomes research.

Jan 1, 2013
Journal Article

Design and Use of Performance Measures to Decrease Low-Value Services and Achieve Cost-Conscious Care

The American College of Physicians recently launched its High-Value Care Initiative to help physicians and patients understand the benefits, harms, and costs of interventions and to determine whether services provide good value.

Jan 1, 2013
Journal Article

Health-related Quality of Life and Quality of Care in Specialized Medicare-managed Care Plans

This research indicates that beneficiaries in 3 types of special needs plans show evidence of worse health-related quality of life.

Jan 1, 2013
Journal Article

How Well Do Medicare's Pay-for-Performance (P4P) Programs Match Desirable P4P Design Criteria?

Alignment with best P4P practices varies across Medicare programs; the program for Medicare Advantage aligns most strongly. It is unclear which P4P design elements are critical for quality improvement. Unintended consequences of design features are poorly understood.

Jan 1, 2013
Q&A

ACOs: Making Organizations 'Accountable' for Care

The Affordable Care Act focuses primarily on extending coverage to uninsured Americans, but it is also intended to help curb cost growth. M. Susan Ridgely explains one of the key tools for doing that—the “accountable care organization,” an alternative delivery model intended to lower costs while also improving quality of care.

Dec 19, 2012
Research Brief

Providers Influence the Bulk of Health Care Spending in the U.S.

Providers can dramatically improve American health care by focusing on “value” instead of “volume,” eliminating wasteful and inappropriate care, applying the best available evidence to their practices, and enhancing patient safety.

Nov 15, 2012
Journal Article

Medicare Postacute Care Payment Reforms Have Potential To Improve Efficiency Of Care, But May Need Changes To Cut Costs

ACA-mandated payment reforms need to achieve more than a one-time cost saving.

Sep 1, 2012
Blog

A Cure for Overtreatment: RAND Guidelines for Appropriate Care

Reducing inappropriate and wasteful tests, treatments and procedures has the potential to save billions annually and simultaneously improve the quality and safety of American medicine, writes Art Kellermann.

Aug 9, 2012

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