Medicare

Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Medicare Collects Quality Performance Data across Many Settings and Conditions

For the FFS program, Medicare currently collects data on quality measures for six different health care settings:

Performance Measures Currently Reported to

Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Performance Measures Currently Reported to Medicare

We catalogued performance measures that are being reported to Medicare as of 2008, finding that Medicare is collecting a significant number of performance measures; however these efforts currently are single setting and provider focused and they emphasizes assessment of the provision of discrete services rather than the full spectrum of services w

Where Differential Payment Policies Exist, the

Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Where Differential Payment Policies Exist, the Focus is on Reporting of Performance

Differential payments to providers currently reflect additional payments for reporting rather than actual performance. As of July 2008, Medicare had pay-for-reporting programs in place for the hospital inpatient, hospital outpatient, and home health settings; these programs require providers to voluntarily report on a defined set of performance

Separate Payment Mechanisms Do not Foster

Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Separate Payment Mechanisms Do not Foster Coordination and Shared Accountabilities

Medicare uses separate payment mechanisms for each of its FFS provider settings and Medicare Advantage plans, and these payments are currently not aligned in ways that foster coordination, shared accountabilities, and delivery of high quality care.

Existing Medicare Provider Payment Approaches

Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Existing Medicare Provider Payment Approaches

We catalogued the provider payment approaches used by Medicare as of 2008, which revealed two important issues of relevance to this project.

Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Executive Summary

Substantial deficits in the quality of health care and persistent and unsustainable growth in health care spending have led to calls for reform of the Medicare system, including such

Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report

Cheryl l. Damberg, Melony E. Sorbero, Peter S. Hussey, Susan Lovejoy, hangsheng liu, and ateev mehrotra WR-633-ASPE February 2009 Assistant Secretary for Planning and Evaluation U.S. Department of Health and Human Services The report was prepared by the contractor (RAND). The findings and conclusions are those of the authors and do not n

report.pdf
PDF

Continuation of Research on Consumer Directed Health Plans: HSA Simulation Model Refinement . Footnotes

1 2006 Blue Book, United States Department of the Treasury, February, 2006. 2 HDHP stands for High Deductible Health Plan. This plan design generally has a substantial deductible and/or coinsurance requirement that must be met before catastrophic health insurance is activated for medical care reimbursement.