Managed Health Care Connect March 17, 2017
In theory, pay-for-performance programs seem simple enough—pay physicians and hospitals based on health outcomes or value of patient care, rather than on quantity of medical services provided. Congress, for example, passed the Medicare Access CHIP Reauthorization Act of 2015 (MACRA) that moves Medicare from a volume-based payment system to one that rewards value. The first performance period under MACRA took effect on January 1, 2017. The 2010 Affordable Care Act has put a lot of time and effort into a variety of new programs on pay-for-performance such as value-based purchasing and the Hospital Readmissions Reduction Program (HRRP). Yet, the evidence supporting pay-for-performance is mixed at best. Studies have shown marginal gains or failure of programs.
The Evidence
Cost of health...
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