NEJM February 9, 2017
Medicare is steadily shifting from volume-based fee-for-service payments to value-based payment models, including accountable care organizations, episode-based bundled payments, and penalties for hospitals with relatively high Medicare readmission rates.1 These models typically provide financial bonuses or penalties related to the efficiency and quality of care, thereby shifting more financial risk to hospitals, medical groups, and other providers. Through a star rating system, bonuses are also provided to high-quality health plans in the Medicare Advantage program.
A growing body of research indicates that social risk factors, including low socioeconomic position (as indicated, for example, by income or educational level), minority race or ethnic background, lower degree of acculturation, minority sexual orientation or gender identity, limited social relationships, and living alone or...
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