Title Systems practices for the care of socially at-risk populations / Committee on Accounting for Socioeconomic Status in Medicare Payment Programs ; Board on Population Health and Public Health Practice ; Board on Health Care Services ; Health and Medicine Division ; National Academies of Sciences, Engineering, and Medicine

Published Washington, D.C. : National Academies Press, [2016]

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Description 1 online resource (1 PDF file (xi, 82 pages)) : illustrations Contents Pages:1 to 10; Pages:11 to 20; Pages:21 to 30; Pages:31 to 40; Pages:41 to 50; Pages:51 to 60; Pages:61 to 70; Pages:71 to 80; Pages:81 to 90; Pages:91 to 95 Summary The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act Bibliography Includes bibliographical references Notes This activity was supported by Contract No. HHSP233201400020B from the Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project Online resource; title from PDF title page (viewed September 2, 2016) Subject Centers for Medicare & Medicaid Services (U.S.) United States. Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act of 2014. SUBJECT Centers for Medicare & Medicaid Services (U.S.) United States Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act of 2014 Centers for Medicare & Medicaid Services (U.S.) fast Subject Medical care -- United States -- Finance Medicaid -- Finance Medicare -- Finance Medicare -- economics Medicaid -- economics Population Characteristics BUSINESS & ECONOMICS -- Industries -- General. Medicaid -- Finance Medical care -- Finance Medicare -- Finance SUBJECT United States https://id.nlm.nih.gov/mesh/D014481 Subject United States Form Electronic book Author National Academies of Sciences, Engineering, and Medicine (U.S.). Committee on Accounting for Socioeconomic Status in Medicare Payment Programs, issuing body. ISBN 9780309391986 0309391989

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