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Paying for value: replacing Medicare's sustainable growth rate formula with incentives to improve care.
Issue Brief (Commonw Fund). 2013 Mar; 16:1-10.IB

Abstract

This brief sets forth a set of policy options to improve the way health care providers are paid by Medicare. The authors suggest repealing Medicare's sustain­able growth rate (SGR) formula for physician fees and replacing it with a pay-for-value approach that would: 1) increase payments over time only for physicians and other provid­ers who participate in innovative care arrangements; 2) strengthen primary care and care teams; and 3) implement bundled payments for hospital-related care. These reforms would be adopted by Medicare, Medicaid, and private plans in the new insurance marketplaces, with the goal of accelerating innovation in care delivery throughout the health system. Together, these policies could more than offset the cost of repealing the SGR formula, saving $788 billion for the federal government over 10 years and $1.3 trillion nationwide. Savings also would accrue to state and local governments ($163 billion), private employ­ers ($91 billion), and households ($291 billion).

Authors+Show Affiliations

Commission on a High Performance Health System, USA. sxg@cmwf.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23547336

Citation

Guterman, Stuart, et al. "Paying for Value: Replacing Medicare's Sustainable Growth Rate Formula With Incentives to Improve Care." Issue Brief (Commonwealth Fund), vol. 16, 2013, pp. 1-10.
Guterman S, Zezza MA, Schoen C. Paying for value: replacing Medicare's sustainable growth rate formula with incentives to improve care. Issue Brief (Commonw Fund). 2013;16:1-10.
Guterman, S., Zezza, M. A., & Schoen, C. (2013). Paying for value: replacing Medicare's sustainable growth rate formula with incentives to improve care. Issue Brief (Commonwealth Fund), 16, 1-10.
Guterman S, Zezza MA, Schoen C. Paying for Value: Replacing Medicare's Sustainable Growth Rate Formula With Incentives to Improve Care. Issue Brief (Commonw Fund). 2013;16:1-10. PubMed PMID: 23547336.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paying for value: replacing Medicare's sustainable growth rate formula with incentives to improve care. AU - Guterman,Stuart, AU - Zezza,Mark A, AU - Schoen,Cathy, PY - 2013/4/4/entrez PY - 2013/4/4/pubmed PY - 2013/4/30/medline SP - 1 EP - 10 JF - Issue brief (Commonwealth Fund) JO - Issue Brief (Commonw Fund) VL - 16 N2 - This brief sets forth a set of policy options to improve the way health care providers are paid by Medicare. The authors suggest repealing Medicare's sustain­able growth rate (SGR) formula for physician fees and replacing it with a pay-for-value approach that would: 1) increase payments over time only for physicians and other provid­ers who participate in innovative care arrangements; 2) strengthen primary care and care teams; and 3) implement bundled payments for hospital-related care. These reforms would be adopted by Medicare, Medicaid, and private plans in the new insurance marketplaces, with the goal of accelerating innovation in care delivery throughout the health system. Together, these policies could more than offset the cost of repealing the SGR formula, saving $788 billion for the federal government over 10 years and $1.3 trillion nationwide. Savings also would accrue to state and local governments ($163 billion), private employ­ers ($91 billion), and households ($291 billion). SN - 1558-6847 UR - https://www.unboundmedicine.com/medline/citation/23547336/Paying_for_value:_replacing_Medicare's_sustainable_growth_rate_formula_with_incentives_to_improve_care_ L2 - https://medlineplus.gov/medicare.html DB - PRIME DP - Unbound Medicine ER -