RevCycle Intelligence June 20, 2017
Misaligned healthcare payment incentives topped the list of challenges providers and payers faced when implementing effective care management programs under Medicare Advantage plans with capitated payments, a recent Robert Graham Center for Policy Studies in Family Medicine and Primary Care report stated.
“Absent coordination of incentives, care management programs often result in offices hosting multiple care managers,” researchers wrote. “Different care managers can run services and inclusion criteria. This leads to confusion for both the patient and provider, and distraction from the objectives of each program.”
Using data from a literature review, expert insights, and site visits to successful models in the field, researchers found that risk-based capitated payments under Medicare Advantage plans offered the greatest opportunity to advance care...
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