Committee on Geographic Adjustment Factors in Medicare Payment's Books

Geographic Adjustment in Medicare Payment

Phase II: Implications for Access, Quality, and Efficiency

By: Institute of Medicine,Board on Health Care Services,Committee on Geographic Adjustment Factors in Medicare Payment

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Geographic Adjustment in Medicare Payment

Phase II: Implications for Access, Quality, and Efficiency

By: Institute of Medicine,Board on Health Care Services,Committee on Geographic Adjustment Factors in Medicare Payment

Medicare, the world's single largest health insurance program, covers more than 47 million Americans. Although it is a national program, it adjusts payments to hospitals and health care practitioners according to the geographic location in which they provide service, acknowledging that the cost of doing business varies around the country. Under the adjustment systems, payments in high-cost areas are increased relative to the national average, and payments in low-cost areas are reduced. In July 2010, the Department of Health and Human Services, which oversees Medicare, commissioned the IOM to conduct a two-part study to recommend corrections of inaccuracies and inequities in geographic adjustments to Medicare payments. The first report examined the data sources and methods used to adjust payments, and recommended a number of changes. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency applies the first report's recommendations in order to determine their potential effect on Medicare payments to hospitals and clinical practitioners. This report also offers recommendations to improve access to efficient and appropriate levels of care. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency expresses the importance of ensuring the availability of a sufficient health care workforce to serve all beneficiaries, regardless of where they live.

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262

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National Academies Press

Published Date

ISBN 10

0309258014

ISBN 13

9780309258012

Geographic Adjustment in Medicare Payment

Phase I: Improving Accuracy

By: Institute of Medicine,Board on Health Care Services,Committee on Geographic Adjustment Factors in Medicare Payment

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Geographic Adjustment in Medicare Payment

Phase I: Improving Accuracy

By: Institute of Medicine,Board on Health Care Services,Committee on Geographic Adjustment Factors in Medicare Payment

Medicare is the largest health insurer in the United States, providing coverage for 39 million people aged 65 and older and 8 million people with disabilities, and reaching more than an estimated $500 billion in payments in 2010. Although Medicare is a national program, it adjusts fee-for-service payments according to the geographic location of a practice. While there is widespread agreement about the importance of providing accurate payments to providers, there is disagreement about how best to adjust payment based on geographic location. At the request of Congress and the Department of Health and Human Services (HHS), the Institute of Medicine (IOM) examined ways to improve the accuracy of data sources and methods used for making the geographic adjustments to payments. The IOM recommends an integrated approach that includes moving to a single source of wage and benefits data; changing to one set of payment areas; and expanding the range of occupations included in the index calculations. The first of two reports, Geographic Adjustment in Medicare Payment: Phase I: Improving Accuracy, assesses existing practices in regards to accuracy, criteria consistency, evidence for adjustment, sound rationale, transparency, and separate policy adjustments to reform the current payment system. Adopting the recommendations outlined in this report will mean a change in the way that the indexes are calculated, and will require a combination of legislative, rule-making, and administrative actions, as well as a period of public comment. Geographic Adjustment in Medicare Payment will inform the work of government agencies such as HHS, the Centers for Medicare and Medicaid Services, congressional members and staff, the health care industry, national professional organizations and state medical and nursing societies, and Medicare advocacy groups.

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236

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National Academies Press

Published Date

ISBN 10

030921145X

ISBN 13

9780309211451

Geographic Adjustment in Medicare Payment

Phase I: Improving Accuracy

By: Institute of Medicine,Board on Health Care Services,Committee on Geographic Adjustment Factors in Medicare Payment

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Geographic Adjustment in Medicare Payment

Phase I: Improving Accuracy

By: Institute of Medicine,Board on Health Care Services,Committee on Geographic Adjustment Factors in Medicare Payment

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236

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National Academies Press

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ISBN 10

030921145X

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9780309211451

Eco-terrorism Specifically Examining the Earth Liberation Front and the Animal Liberation Front

Hearing Before the Committee on Environment and Public Works, United States Senate, One Hundred Ninth Congress, First Session, May 18, 2005

By: United States. Congress. Senate. Committee on Environment and Public Works

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Eco-terrorism Specifically Examining the Earth Liberation Front and the Animal Liberation Front

Hearing Before the Committee on Environment and Public Works, United States Senate, One Hundred Ninth Congress, First Session, May 18, 2005

By: United States. Congress. Senate. Committee on Environment and Public Works

The Code of Federal Regulations is a codification of the general and permanent rules published in the Federal Register by the Executive departments and agencies of the United States Federal Government.

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860

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Office of the Federal Register

Published Date

ISBN 10

0160793181

ISBN 13

9780160793189

Accounting for Social Risk Factors in Medicare Payment

Criteria, Factors, and Methods

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Board on Population Health and Public Health Practice,Committee on Accounting for Socioeconomic Status in Medicare Payment Programs

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Accounting for Social Risk Factors in Medicare Payment

Criteria, Factors, and Methods

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.

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125

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National Academies Press

Published Date

ISBN 10

0309442931

ISBN 13

9780309442930

Accounting for Social Risk Factors in Medicare Payment

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Accounting for Social Risk Factors in Medicare Payment

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.

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581

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National Academies Press

Published Date

ISBN 10

0309449200

ISBN 13

9780309449205

Accounting for Social Risk Factors in Medicare Payment

Identifying Social Risk Factors

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Board on Population Health and Public Health Practice,Committee on Accounting for Socioeconomic Status in Medicare Payment Programs

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Accounting for Social Risk Factors in Medicare Payment

Identifying Social Risk Factors

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.

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Page Count

111

Publisher

National Academies Press

Published Date

ISBN 10

0309381274

ISBN 13

9780309381277

Book's by Committee on Geographic Adjustment Factors in Medicare Payment

Geographic Adjustment in Medicare Payment

Geographic Adjustment in Medicare Payment

Geographic Adjustment in Medicare Payment

Geographic Adjustment in Medicare Payment

Geographic Adjustment in Medicare Payment

Geographic Adjustment in Medicare Payment

Eco-terrorism Specifically Examining the Earth Liberation Front and the Animal Liberation Front

Eco-terrorism Specifically Examining the Earth Liberation Front and the Animal Liberation Front

Accounting for Social Risk Factors in Medicare Payment

Accounting for Social Risk Factors in Medicare Payment

Accounting for Social Risk Factors in Medicare Payment

Accounting for Social Risk Factors in Medicare Payment

Accounting for Social Risk Factors in Medicare Payment

Accounting for Social Risk Factors in Medicare Payment

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