Accounting for Social Risk Factors in Medicare Payment (2017) / Chapter Skim
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B1: Introduction
B1: Introduction
Pages 229-236
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From page 229... ...
, which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the P atient Protection and Affordable Care Act in 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models such as bundled (episode-based)
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Thus, when considering the effect on health equity of VBP, there will always be an inherent tension between fairness to providers and improving health care and health outcomes for socially at-risk populations. This tension has led some to advocate for accounting for social risk factors in payment methods to promote fairness for providers, and spurred others to implement interventions to address social risk factors to improve health outcomes for socially at-risk populations.
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contracted with the National Academies of Sciences, Engineering, and Medicine to convene an ad hoc committee to identify the best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compare those best practices to practices of lowperforming providers serving similar patient populations. The committee comprises expertise in health care quality, clinical medicine, health services research, health disparities, social determinants of health, risk adjustment, and edicare programs (see Appendix F for biographical sketches)
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The second report will: • dentify best practices of high-performing hospitals, health plans, and other I providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compare those best practices to practices of low-performing providers serving similar patient populations. The third report will: • pecify criteria (along with their strengths and weaknesses)
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These organizations submit r ted 60 case studies for the committee's consideration. As will be described in detail in Appendix B2, the committee identified key themes and commonalities in practices that were shown to improve health care quality and health outcomes for socially at-risk populations in specific provider settings and in specific community contexts.
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2007. Pay for performance, public reporting, and racial disparities in health care: How are programs being designed?
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In Report to the Congress: Medicare and the health care delivery system. Washington, DC: MedPAC.
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