Title Accounting for social risk factors in Medicare payment. Criteria, factors, and methods / 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, the National Academies of Sciences, Engineering, Medicine

Published Washington, DC : The National Academies Press, [2016]

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Description 1 online resource (1 PDF file (x, 114 pages)) Contents Summary -- Introduction -- Criteria for selecting social risk factors for application in Medicare quality measurement and payment -- Applying selection criteria to social risk factors and health literacy -- Methods to account for social risk factors in Medicare value-based payment -- Appendix A: Criteria for selecting risk factors reviewed by the Committee -- Appendix B: Committee biosketches Summary 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 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 November 29, 2016) Subject Medicare -- Cost control Outcome assessment (Medical care) Medicare -- economics Healthcare Disparities Outcome and Process Assessment, Health Care Risk Factors Socioeconomic Factors Value-Based Purchasing BUSINESS & ECONOMICS -- Insurance -- Risk Assessment & Management. Outcome assessment (Medical care) Medicare -- Cost control SUBJECT United States https://id.nlm.nih.gov/mesh/D014481 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 9780309442930 0309442931 9780309442947 030944294X

Other Titles Criteria, factors, and methods

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