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Accounting for Social Risk Factors in Medicare Payment (Paperback)
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Accounting for Social Risk Factors in Medicare Payment (Paperback)
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Recent health care payment reforms aim to improve the alignment of
Medicare payment strategies with goals to improve the quality of
care provided, patient experiences with health care, and health
outcomes, while also controlling costs. These efforts move Medicare
away from the volume-based payment of traditional fee-for-service
models and toward value-based purchasing, in which cost control is
an explicit goal in addition to clinical and quality goals.
Specific payment strategies include pay-for-performance and other
quality incentive programs that tie financial rewards and sanctions
to the quality and efficiency of care provided and accountable care
organizations in which health care providers are held accountable
for both the quality and cost of the care they deliver. Accounting
For Social Risk Factors in Medicare Payment is the fifth and final
report in a series of brief reports that aim to inform ASPE
analyses that account for social risk factors in Medicare payment
programs mandated through the IMPACT Act. This report aims to put
the entire series in context and offers additional thoughts about
how to best consider the various methods for accounting for social
risk factors, as well as next steps. Table of Contents Front Matter
Summary 1 Introduction 2 Social Risk Factors: Definitions and Data
3 Methods to Account for Social Risk Factors 4 Moving Forward
Appendix A: Identifying Social Risk Factors AS: Summary A1:
Introduction A2: Social Risk Factors AA: Overview of Medicare
Value-Based Payment Programs Appendix B: Systems Practices for the
Care of Socially At-Risk Populations BS: Summary B1: Introduction
B2: Improving Care for Socially At-Risk Populations BA: Example
Implementation Strategies and Case Studies Appendix C: Criteria,
Factors, and Methods CS: Summary C1: Introduction C2: Criteria for
Selecting Social Risk Factors for Application in Medicare Quality
Measurement and Payment C3: Applying Selection Criteria to Social
Risk Factors and Health Literacy C4: Methods to Account for Social
Risk Factors in Medicare Value-Based Payment CA: Criteria for
Selecting Risk Factors Reviewed by the Committee Appendix D: Data
DS: Summary D1: Introduction D2: Potential Data Sources D3: Data
Sources and Data Collection for Social Risk Factors Appendix E:
Prior Conclusions and Recommendations Appendix F: Committee
Biosketches Index
General
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