Medicare At Risk
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Accounting For Social Risk Factors In Medicare Payment
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2017-05-18
Accounting For Social Risk Factors In Medicare Payment written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-05-18 with Medical categories.
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.
Accounting For Social Risk Factors In Medicare Payment
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2016-01-12
Accounting For Social Risk Factors In Medicare Payment written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-01-12 with Medical categories.
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: Identifying Social Risk Factors is the first in a series of five reports commissioned to provide input into whether socioeconomic status (SES) and other social risk factors could be accounted for in Medicare payment and quality programs. This report focuses on defining SES and other social factors for the purposes of application to Medicare quality measurement and payment programs.
Report To The Congress
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Author :
language : en
Publisher:
Release Date : 2000
Report To The Congress written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2000 with Health insurance categories.
Accounting For Social Risk Factors In Medicare Payment
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2016-08-13
Accounting For Social Risk Factors In Medicare Payment written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-08-13 with Medical categories.
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: Criteria, Factors, and Methods is the third in a series of five 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 builds on the conceptual relationships and empirical associations between social risk factors and performance indicators used in value-based payment identified in the first report to provide guidance on which factors could be considered for Medicare accounting purposes, criteria to identify these factors, and methods to do so in ways that can improve care and promote greater health equity for socially at-risk patients.
Medicare Risk And Capitation
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Author : HCIA (Firm)
language : en
Publisher:
Release Date : 1996-01-01
Medicare Risk And Capitation written by HCIA (Firm) and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1996-01-01 with categories.
Profiles Of
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Author :
language : en
Publisher:
Release Date : 1996
Profiles Of written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1996 with Aged categories.
Medicare At Risk
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Author : United States. Congress. Senate. Committee on Governmental Affairs. Permanent Subcommittee on Investigations
language : en
Publisher:
Release Date : 1997
Medicare At Risk written by United States. Congress. Senate. Committee on Governmental Affairs. Permanent Subcommittee on Investigations and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1997 with Family & Relationships categories.
Medicare Choice An Examination Of The Risk Adjuster
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Author : United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment
language : en
Publisher:
Release Date : 1999
Medicare Choice An Examination Of The Risk Adjuster written by United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Medical categories.
Medicare Advantage
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Author : U.s. Government Accountability Office
language : en
Publisher: Createspace Independent Publishing Platform
Release Date : 2017-08-17
Medicare Advantage written by U.s. Government Accountability Office and has been published by Createspace Independent Publishing Platform this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-08-17 with categories.
"The Centers for Medicare & Medicaid Services (CMS) pays plans in Medicare Advantage (MA)-the private plan alternative to Medicare fee-for-service (FFS)-an amount per beneficiary that is adjusted to reflect beneficiary health status. This adjustment, called risk adjustment, helps ensure that health plans have the same financial incentive to enroll and care for beneficiaries regardless of their health status. In 2010, CMS announced plans to revise the major medical conditions included in its principal risk-adjustment model-the community model-and add a model for new enrollees in chronic condition special needs plans (C-SNP), which target beneficiaries with certain severe or disabling chronic conditions. CMS began using the C-SNP new enrollee model in 2011, in place of the general new enrollee model, to adjust MA payments for new Medicare beneficiaries who enroll in a C-SNP. GAO was asked to examine the accuracy of these models for high-risk beneficiaries. Using data for a nationally representative sample of 2007 FFS beneficiaries, GAO computed the amount that expenditure estimates were above or below actual expenditures for 2007, the most recent data available at the time. GAO compared the accuracy of the current and revised community models for three high-risk groups: beneficiaries with multiple chronic conditions, with low income, and with dementia. GAO compared the accuracy of the general and C-SNP new enrollee models for new enrollees eligible to enroll in a C-SNP. What GAO Found The effect of CMS's revised community model on payment accuracy varied for the high-risk groups studied. Specifically, compared with the current community model, the revised community model slightly reduced the accuracy of MA payment adjustments for beneficiaries with multiple chronic conditions by $164, or about 1 percent of average actual expenditures. For beneficiaries with low income, the accuracy of the revised and the current community models was similar: estimates differed by $5, o..."
Medicare And Health Care Chartbook
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Author : United States. Congress. House. Committee on Ways and Means
language : en
Publisher:
Release Date : 1997
Medicare And Health Care Chartbook written by United States. Congress. House. Committee on Ways and Means and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1997 with Business & Economics categories.