Accounting for Social Risk Factors in Medicare Payment

National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Board on Population Health and Public Health Practice,Committee on Accounting for Socioeconomic Status in Medicare Payment Programs

Accounting for Social Risk Factors in Medicare Payment
Format
Paperback
Publisher
National Academies Press
Country
United States
Published
18 June 2017
Pages
580
ISBN
9780309449205

Accounting for Social Risk Factors in Medicare Payment

National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Board on Population Health and Public Health Practice,Committee on Accounting for Socioeconomic Status in Medicare Payment Programs

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 is the fifth and final report in a series of 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 aims to put the entire series in context and offers additional thoughts about how to best consider the various methods for accounting for social risk factors, as well as next steps.

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