• Front Matter R1-R22

• Summary: Implications of Geographic Adjustment for Access, Quality, and Efficiency of Care 1-12

• 1 Introduction and Overview 13-22

• 2 Payment Simulations 23-50

• 3 Evidence of Geographic Variation in Access, Quality, and Workforce Distribution 51-90

• 4 Programs and Policies to Improve Access and Quality of Care for Beneficiaries 91-124

• 5 Observations on the Larger Policy Context 125-134

• 6 Recommendations 135-142

• Appendix A-1: Technical Approach to Payment Simulations: IOM Committee Recommendations for Hospital Wage Index and Physician Geographic Adjustment Factors 143-172

• Appendix A-2: Payment Simulations: Data Tables 173-174

• Appendix B: Methods for the Analysis of Associations of Quality Measures with Payments in Chapter 3 175-182

• Appendix C: Quality Assurance for RTI Payment Simulations 183-186

• Appendix D: Public Session: Workforce, Access, and Innovation Policy Levers for Geographic Adjustment In Medicare Payment 187-188

• Appendix E: Exchange of Letters Between House of Representatives Quality Coalition and Committee Chair Frank Sloan 189-194

• Appendix F: Committee and Staff Biographies 195-208

• Index 209-216

Committee on Geographic Adjustment Factors in Medicare Payment, Board on Health Care Services, Institute of Medicine " Summary: Implications of Geographic Adjustment for Access, Quality, and Efficiency of Care ." Geographic Adjustment in Medicare Payment: Phase II: Implications for Access, Quality, and Efficiency . Washington, DC: The National Academies Press, 2012 .

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