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Pay for performance systems link compensation to measures of work quality or goals. Current methods of healthcare payment may actually reward less-safe care, since some insurance companies will not pay for new practices to reduce errors, while physicians and hospitals can bill for additional services that are needed when patients are injured by mistakes. [1]
In a value-based care model, providers would work with patients to determine a treatment plan, then measure the relevant clinical results over the course of the patient's treatment. [4] [10] [5] There is debate as to whether patient experience and satisfaction with the quality of their care is a component of value-based care.
The Center for Medicare and Medicaid Innovation (CMMI; also known as the CMS Innovation Center) is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). [1] It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation.
Value-based insurance design (also V-BID, VBID, evidence-based benefit design, or value-based benefit design) is a demand-side approach to health policy reform.V-BID generally refers to health insurers' efforts to structure enrollee cost-sharing and other health plan design elements to encourage enrollees to consume high-value clinical services – those that have the greatest potential to ...
Another model HHS proposed for testing looked into whether CMS could coordinate multi-state outcomes-based agreements (OBA) with manufacturers of high-cost specialty drug, instead of having state ...
In 2006 the Tax Relief and Health Care Act (TRHCA) included a provision for a 1.5% incentive payment to eligible providers who successfully submitted quality data to CMS. This provision included a cap on payments. The 2007 Medicare, Medicaid, and SCHIP Extension Act extended the program through 2008 and 2009. It also removed the TRHCA payment cap.
The mission of the SHCC is "to enhance the patient experience – encompassing access, convenience, affordability, and quality – by working together towards achieving smarter health care, with a focus on integrating benefit design innovations and consumer/patient engagement within broader delivery system reform in order to better align ...
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