Health Affairs May 2, 2018
Under fee-for-service Medicare in the US, hospitalizations with use of life-sustaining treatment such as mechanical ventilation are incentivized despite typically nominal benefits. The reimbursement system and the pathway of least resistance are aligned with “doing more” instead of focusing on in-depth conversations or formulating and executing plans of care that promote person- and family-centered care. In the US, the Affordable Care Act (ACA) and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) aim to shift these incentives from volume-based to value-based, partly through the use of alternative payment models (APMs).
The Physician-Focused Payment Model Technical Advisory Committee (PTAC) approved two new APMs that will provide per-monthly payment for the care of seriously ill people. Individuals under the care...
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