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Accounting for Social Risk Factors in Medicare Payment (2017)

Chapter: Appendix C: Criteria, Factors, and Methods

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Suggested Citation:"Appendix C: Criteria, Factors, and Methods." National Academies of Sciences, Engineering, and Medicine. 2017. Accounting for Social Risk Factors in Medicare Payment. Washington, DC: The National Academies Press. doi: 10.17226/23635.
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C

Criteria, Factors, and Methods

Appendix C reproduces in its entirety the third report from the Committee on Accounting for Socioeconomic Status in Medicare Payment Programs. The committee made no substantive content changes. This report was originally released on July 13, 2016, as:

National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for social risk factors in Medicare payment: Criteria, factors, and methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.

Suggested Citation:"Appendix C: Criteria, Factors, and Methods." National Academies of Sciences, Engineering, and Medicine. 2017. Accounting for Social Risk Factors in Medicare Payment. Washington, DC: The National Academies Press. doi: 10.17226/23635.
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Suggested Citation:"Appendix C: Criteria, Factors, and Methods." National Academies of Sciences, Engineering, and Medicine. 2017. Accounting for Social Risk Factors in Medicare Payment. Washington, DC: The National Academies Press. doi: 10.17226/23635.
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Page 311
Suggested Citation:"Appendix C: Criteria, Factors, and Methods." National Academies of Sciences, Engineering, and Medicine. 2017. Accounting for Social Risk Factors in Medicare Payment. Washington, DC: The National Academies Press. doi: 10.17226/23635.
×
Page 312
Suggested Citation:"Appendix C: Criteria, Factors, and Methods." National Academies of Sciences, Engineering, and Medicine. 2017. Accounting for Social Risk Factors in Medicare Payment. Washington, DC: The National Academies Press. doi: 10.17226/23635.
×
Page 313
Suggested Citation:"Appendix C: Criteria, Factors, and Methods." National Academies of Sciences, Engineering, and Medicine. 2017. Accounting for Social Risk Factors in Medicare Payment. Washington, DC: The National Academies Press. doi: 10.17226/23635.
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Page 314
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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.

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