CHQPR June 19, 2022
Harold D. Miller

A major weakness in traditional fee-for-service payment is that healthcare providers are paid for delivering a service regardless of the quality or appropriateness of the service. Value-based payment programs have attempted to correct this by paying bonuses or imposing penalties on providers based on various types of quality measures.

These programs assume that higher scores on quality measures mean that patients are receiving higher-quality care. Unfortunately, in many cases, the exact opposite is true. As a result, current quality measures can cause physicians and hospitals to be penalized for providing the most appropriate care for patients and to be rewarded for delivering lower-quality care. This has the potential to exacerbate health disparities rather than improve quality and value.

Example: Measuring the Quality of Diabetes...

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Topics: CMS, Govt Agencies, Insurance, Medicare, Payment Models, Provider, Value Based
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