National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Blood Clots (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (2)
- Colonoscopy (1)
- Diagnostic Safety and Quality (1)
- Dialysis (1)
- Elderly (2)
- Emergency Department (2)
- Falls (1)
- Healthcare-Associated Infections (HAIs) (4)
- Healthcare Costs (19)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Health Information Exchange (HIE) (1)
- Health Insurance (9)
- Health Services Research (HSR) (1)
- Health Systems (2)
- Hospital Discharge (3)
- Hospitalization (3)
- Hospital Readmissions (3)
- Hospitals (15)
- Implementation (1)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (2)
- Long-Term Care (1)
- Medicaid (6)
- Medicare (21)
- Newborns/Infants (1)
- Nursing Homes (4)
- Organizational Change (1)
- Orthopedics (2)
- Patient Safety (2)
- (-) Payment (45)
- Policy (7)
- Practice Patterns (3)
- Prevention (2)
- Primary Care (1)
- Provider (1)
- Provider: Health Personnel (1)
- Provider: Physician (1)
- Provider Performance (11)
- Quality Improvement (3)
- Quality Indicators (QIs) (3)
- Quality of Care (9)
- Racial and Ethnic Minorities (1)
- Screening (1)
- Sepsis (1)
- Social Determinants of Health (2)
- Surgery (5)
- Vaccination (1)
- Vulnerable Populations (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 45 Research Studies DisplayedHider AM, Gomez-Rexrode AE, Agius J
Association of bundled payments with spending, utilization, and quality for surgical conditions: a scoping review.
This scoping review assessed the body of literature examining episode-based bundled payment models effect on health care spending, utilization, and quality of care for surgical conditions. Bundled payment models let hospitals receive financial incentives to reduce spending on care provided to patients during a predefined clinical episode. The review queried four databases from inception through September 27, 2021. A total of 879 unique articles were found, of which 28 met final inclusion criteria. Of these studies, 23 out of 28 evaluated the impact of voluntary bundled payments in orthopedic surgery and found that bundled payments are associated with reduced spending on total care episodes, attributed primarily to decreases in post-acute care spending. This reduced spending did not worsen clinical outcomes (e.g., readmissions, complications, and mortality). Evidence for non-orthopedic surgery bundled payments remains limited.
AHRQ-funded; HS028606.
Citation: Hider AM, Gomez-Rexrode AE, Agius J .
Association of bundled payments with spending, utilization, and quality for surgical conditions: a scoping review.
Am J Surg 2024 Mar; 229:83-91. doi: 10.1016/j.amjsurg.2023.12.009.
Keywords: Surgery, Payment, Healthcare Costs
Huffstetler AN, Phillips RL
Payment structures that support social care integration with clinical care: social deprivation indices and novel payment models.
This perspective article focuses on four models employed both internationally and domestically to outline the implementation, successes, limitations, and research needed to support national application of social determinants of health (SDH) models. The association between high social risk and poor medical outcomes has been established globally; however, healthcare payment policies designed to respond to this relationship generally lack evidence of affecting outcomes. In countries with a legacy of adjusting healthcare payments for social risk, more robust evaluation of associated effects could be helpful. Payers, states, or health systems making similar resource commitments should build in robust longitudinal evaluations of outcomes to inform the evolution of their payment policies.
AHRQ-funded; HS026664.
Citation: Huffstetler AN, Phillips RL .
Payment structures that support social care integration with clinical care: social deprivation indices and novel payment models.
Am J Prev Med 2019 Dec;57(6s1):S82-s88. doi: 10.1016/j.amepre.2019.07.011..
Keywords: Payment, Social Determinants of Health, Policy
Rosenthal M, Shortell S, Shah ND
Physician practices in Accountable Care Organizations are more likely to collect and use physician performance information, yet base only a small proportion of compensation on performance data.
The purpose of this study was to characterize the strategies that physician practices use to improve clinician performance and determine their association with accountable care organizations (ACOs) and other payment reforms. The investigators concluded that ACO-affiliated practices are using more performance improvement strategies than other practices, but base only a small fraction of compensation on quality or cost.
AHRQ-funded; HS024075.
Citation: Rosenthal M, Shortell S, Shah ND .
Physician practices in Accountable Care Organizations are more likely to collect and use physician performance information, yet base only a small proportion of compensation on performance data.
Health Serv Res 2019 Dec;54(6):1214-22. doi: 10.1111/1475-6773.13238..
Keywords: Provider Performance, Payment, Quality Improvement, Quality of Care
Werner RM, Konetzka RT, Qi M
The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs.
The objective of this study was to investigate the impact of Medicare's skilled nursing facility (SNF) copayment policy, with a large increase in the daily copayment rate on the 20th day of a benefit period, on length of stay, patient outcomes, and costs. The investigators concluded that Medicare's SNF copayment policy was associated with shorter lengths of stay and worse patient outcomes, suggesting the copayment policy had unintended and negative effects on patient outcomes.
AHRQ-funded; HS024266.
Citation: Werner RM, Konetzka RT, Qi M .
The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs.
Health Serv Res 2019 Dec;54(6):1184-92. doi: 10.1111/1475-6773.13227..
Keywords: Medicare, Nursing Homes, Payment, Long-Term Care, Healthcare Costs, Elderly, Hospitalization, Hospital Discharge
Sun EC, Mello MM, Moshfegh J
Assessment of out-of-network billing for privately insured patients receiving care in in-network hospitals.
This retrospective analysis used data from the Clinformatics Data Mart database (Optum) to examine out-of-network billing among privately insured patients with an inpatient admission or emergency department (ED) visit at in-network hospitals. The investigators found that out-of-network billing appeared to have become common for privately insured patients even when they soughttreatment at in-network hospitals. They indicated that the mean amounts billed appeared to be sufficiently large that they may create financial strain for a substantial proportion of patients.
AHRQ-funded; HS026128.
Citation: Sun EC, Mello MM, Moshfegh J .
Assessment of out-of-network billing for privately insured patients receiving care in in-network hospitals.
JAMA Intern Med 2019 Nov;179(11):1453-612. doi: 10.1001/jamainternmed.2019.3451..
Keywords: Health Insurance, Healthcare Costs, Payment, Hospitals, Emergency Department
Sheetz KH, Dimick JB, Englesbe MJ
Hospital-acquired condition reduction program is not associated with additional patient safety improvement.
In 2013 the Centers for Medicare and Medicaid Services announced that it would begin levying penalties against hospitals with the highest rates of hospital-acquired conditions through the Hospital-Acquired Condition Reduction Program. This study evaluates whether the program has been successful in improving patient safety or not. The investigators concluded that the program did not improve patient safety in Michigan beyond existing trends.
AHRQ-funded; HS000053; HS026244.
Citation: Sheetz KH, Dimick JB, Englesbe MJ .
Hospital-acquired condition reduction program is not associated with additional patient safety improvement.
Health Aff 2019 Nov;38(11):1858-65. doi: 10.1377/hlthaff.2018.05504..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Provider Performance, Quality Improvement, Quality of Care, Infectious Diseases, Payment
Wood SJ, Albertson EM, Conrad DA
Accountable care program implementation and effects on participating health care systems in Washington state: a conceptual model.
This study used key informant interviews with health care executives representing 5 large health systems contracted with the Washington State Health Care Authority to provide accountable care network services under the State Innovation Model initiative. Two rounds of semistructured interviews were conducted, and results indicated the need to present a modified conceptual model aligned better with accountable care program (ACP) implementation.
AHRQ-funded; HS013853.
Citation: Wood SJ, Albertson EM, Conrad DA .
Accountable care program implementation and effects on participating health care systems in Washington state: a conceptual model.
J Ambul Care Manage 2019 Oct/Dec;42(4):321-36. doi: 10.1097/jac.0000000000000302..
Keywords: Health Systems, Provider Performance, Organizational Change, Health Services Research (HSR), Payment, Health Insurance, Implementation
Chatterjee P, Qi M, Coe NB
Association between high discharge rates of vulnerable patients and skilled nursing facility copayments.
The authors sought to determine whether patterns of skilled nursing facility (SNF) discharge are associated with the change in Medicare payment responsibility on day 20. They found that Medicare beneficiaries were more often discharged from SNFs on benefit day 20 than on benefit days 19 or 21. Those discharged on day 20 were more likely to be racial/ethnic minorities and to live in areas of lower socioeconomic status compared with those discharged before or after day 20. Their findings suggested an association between disproportionately high SNF discharge rates of vulnerable patients and existing Medicare payment policies. The authors recommended that payment policies be designed with consideration of the potential for such unintended consequences, and that any potential consequences be mitigated by balancing existing payment structures with incentives to provide optimal patient care.
AHRQ-funded; HS024266.
Citation: Chatterjee P, Qi M, Coe NB .
Association between high discharge rates of vulnerable patients and skilled nursing facility copayments.
JAMA Intern Med 2019 Sep;179(9):1296-98. doi: 10.1001/jamainternmed.2019.1209.
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Keywords: Vulnerable Populations, Nursing Homes, Medicare, Payment, Policy, Social Determinants of Health
Kim KL, LI L, Kuang M
Changes in hospital referral patterns to skilled nursing facilities under the Hospital Readmissions Reduction Program.
The objective of this study was to investigate the association between changes in hospital referral patterns to skilled nursing facilities (SNFs) and Hospital Readmissions Reduction Program (HRRP) penalty pressure. Results showed that HRRP did not prompt substantial changes in hospital referral patterns to SNFs, although readmissions for patients referred to SNFs differentially decreased more than for other patients, warranting investigation of other mechanisms underlying readmissions reduction.
AHRQ-funded; HS022882.
Citation: Kim KL, LI L, Kuang M .
Changes in hospital referral patterns to skilled nursing facilities under the Hospital Readmissions Reduction Program.
Med Care 2019 Sep;57(9):695-701. doi: 10.1097/mlr.0000000000001169..
Keywords: Hospitals, Nursing Homes, Hospital Readmissions, Payment, Provider Performance
Shorr RI, Staggs VS, Waters TM
Impact of the hospital-acquired conditions initiative on falls and physical restraints: a longitudinal study.
The Centers for Medicare & Medicaid Services (CMS) implemented the Hospital-Acquired Conditions (HACs) Initiative in October 2008; the CMS no longer reimbursed hospitals for fall injury. The aim of this study was to examine the effects of the 2008 HACs Initiative on the rates of falls, injurious falls, and physical restraint use. The investigators concluded that since the HACs Initiative, there was at best a modest decline in the rates of falls and injurious falls observed primarily in larger, major teaching hospitals. An increase in restraint use was not observed.
AHRQ-funded; HS020627.
Citation: Shorr RI, Staggs VS, Waters TM .
Impact of the hospital-acquired conditions initiative on falls and physical restraints: a longitudinal study.
J Hosp Med 2019 Sep 6;14:E31-E36. doi: 10.12788/jhm.3295..
Keywords: Falls, Adverse Events, Hospitals, Payment, Policy, Elderly
Childrers CP, Dworsky JQ, Kominski G
A comparison of payments to a for-profit dialysis firm from government and commercial insurers.
The authors assessed differences in payments from government and commercial insurers to dialysis clinics through analysis of DaVita’s financial records. They found that, in 2017, commercial insurers paid one of the largest dialysis suppliers 4 times the rate of their government peers. They recommended that reducing payments from commercial insurers, perhaps through increased competition or fixing charges at a percent of Medicare reimbursement, may help alleviate excess spending on dialysis.
AHRQ-funded; HS025079.
Citation: Childrers CP, Dworsky JQ, Kominski G .
A comparison of payments to a for-profit dialysis firm from government and commercial insurers.
JAMA Intern Med 2019 Aug;179(8):1136-38. doi: 10.1001/jamainternmed.2019.0431..
Keywords: Payment, Health Insurance, Kidney Disease and Health, Medicare, Medicaid
Song LD, Newhouse JP, Garcia-De-Albeniz X
Changes in screening colonoscopy following Medicare reimbursement and cost-sharing changes.
This study examined changes in screening colonoscopy rates after Medicare reimbursement and cost-sharing changed when the Affordable Care Act (ACA) was implemented. A 20% random sample of fee-for-service (FFS) Medicare claims from 2002-2012 was used in this study. Screening colonoscopy rates did increase after 2001 when cost-sharing was eliminated but the amount varied depending on the algorithm used to classify the indication.
AHRQ-funded; HS023128.
Citation: Song LD, Newhouse JP, Garcia-De-Albeniz X .
Changes in screening colonoscopy following Medicare reimbursement and cost-sharing changes.
Health Serv Res 2019 Aug;54(4):839-50. doi: 10.1111/1475-6773.13150..
Keywords: Colonoscopy, Healthcare Costs, Healthcare Utilization, Medicare, Payment, Prevention, Screening
Sankaran R, Sukul D, Nuliyalu U
Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study.
This study evaluated the association between hospital penalization in the US Hospital Acquired Condition Reduction Program (HACRP) and changes in clinical outcomes. Out of the total of 724 hospitals were penalized in fiscal year 2015, 708 were included in the study. The majority of the penalized hospitals were large teaching institutions and have a greater share of low-income patients than non-penalized hospitals. After penalization, there was a non-significant change in hospital acquired conditions, 30-day readmission rates, and 30-day mortality. This might mean that disparities in care could be exacerbated.
AHRQ-funded; HS026244.
Citation: Sankaran R, Sukul D, Nuliyalu U .
Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study.
BMJ 2019 Jul 3;366:l4109. doi: 10.1136/bmj.l4109..
Keywords: Health Insurance, Healthcare-Associated Infections (HAIs), Hospitals, Medicare, Patient Safety, Provider Performance, Payment, Quality of Care, Quality Indicators (QIs)
Markovitz AA, Mullangi S, Hollingsworth JM
ACOs and the 1%: changes in spending among high-cost patients following the Medicare shared savings program.
This paper analyzed changes in spending among high-cost patients following the creation of accountable care organizations (ACOs), specifically for the Medicare Shared Savings Program – which is Centers for Medicare and Medicaid Services (CMS) flagship program. Changes in spending for Medicare fee-for-services were analyzed for different spending percentiles (50th, 90th, and 99th) as well as regionally. While there was a reduction in spending, it was not considered statistically significant and has not affected spending within or across regions. However, the authors note that the study is limited by the program’s voluntary nature and may be not a full reflection of the changes.
AHRQ-funded; HS024525; HS024728; HS025615.
Citation: Markovitz AA, Mullangi S, Hollingsworth JM .
ACOs and the 1%: changes in spending among high-cost patients following the Medicare shared savings program.
J Gen Intern Med 2019 Jul;34(7):1116-18. doi: 10.1007/s11606-019-04963-2..
Keywords: Medicare, Healthcare Costs, Payment
Heintzman J, Cottrell E, Angier H
Impact of alternative payment methodology on primary care visits and scheduling.
The authors used electronic health record data to evaluate the impact of Oregon’s Alternative Payment Methodology (APM) on visit and scheduling metrics in the first wave of experiment clinics. They found that APM clinics experienced a greater increase in same-day visits but did not significantly differ from comparators in other visit metrics.
AHRQ-funded; HS022651.
Citation: Heintzman J, Cottrell E, Angier H .
Impact of alternative payment methodology on primary care visits and scheduling.
J Am Board Fam Med 2019 Jul-Aug;32(4):539-49. doi: 10.3122/jabfm.2019.04.180368..
Keywords: Payment, Medicaid, Health Insurance, Policy
Chhabra KR, Ibrahim AM, Thumma JR
Impact of Medicare readmissions penalties on targeted surgical conditions.
The authors used Medicare claims to evaluate the effects of the 2013 expansion of the Hospital Readmissions Reduction Program on risk-adjusted readmission rates, episode payments, lengths-of-stay, and observation status use for hip and knee replacement surgery. They found that medical readmission penalties led to readmission reductions for surgical patients, that targeted surgical penalties did not have an additional effect, and that readmission reductions are approaching a point below which further reductions may be unlikely.
AHRQ-funded; HS000053.
Citation: Chhabra KR, Ibrahim AM, Thumma JR .
Impact of Medicare readmissions penalties on targeted surgical conditions.
Health Aff 2019 Jul;38(7):1207-15. doi: 10.1377/hlthaff.2019.00096..
Keywords: Surgery, Hospital Readmissions, Orthopedics, Payment
Zhu JM, Navathe A, Yuan Y
Medicare's bundled payment model did not change skilled nursing facility discharge patterns.
The purpose of this study was to evaluate whether participation in Medicare's voluntary Bundled Payments for Care Improvement (BPCI) model was associated with changes in discharge referral patterns to skilled nursing facilities (SNFs), specifically number of SNF partners and discharge concentration. The investigators concluded that hospital participation in BPCI was not associated with changes in the number of SNF partners or in discharge concentration relative to non-BPCI hospitals.
AHRQ-funded; HS024266.
Citation: Zhu JM, Navathe A, Yuan Y .
Medicare's bundled payment model did not change skilled nursing facility discharge patterns.
Am J Manag Care 2019 Jul;25(7):329-34..
Keywords: Medicare, Payment, Practice Patterns, Hospital Discharge, Nursing Homes
Mitchell AP, Rotter JS, Patel E
Association between reimbursement incentives and physician practice in oncology: a systematic review.
Investigators sought to evaluate whether the financial incentives presented by oncology reimbursement policies affect physician practice patterns. Following a literature search, 18 observational cohort studies were included, most with moderate risk of bias. The findings suggested that some oncologists may, in certain circumstances, alter treatment recommendations based on personal revenue considerations. The authors concluded that an implication of this finding is that value-based reimbursement policies may be a useful tool to better align physician incentives with patient need and increase the value of oncology care.
AHRQ-funded; HS000032.
Citation: Mitchell AP, Rotter JS, Patel E .
Association between reimbursement incentives and physician practice in oncology: a systematic review.
JAMA Oncol 2019 Jun;5(6):893-99. doi: 10.1001/jamaoncol.2018.6196..
Keywords: Practice Patterns, Payment, Provider: Physician, Provider
Kaplan CM, Thompson MP, Waters TM
How have 30-day readmission penalties affected racial disparities in readmissions?: an analysis from 2007 to 2014 in five US states.
The purpose of this study was to examine changes in Black-White disparities in 30-day readmissions for acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia following the passage and implementation of the Hospital Readmission Reduction Program (HRRP), and to compare disparities across safety-net and non-safety-net hospitals. Prior to the passage of HRRP, Black and White readmission rates and disparities in readmissions were decreasing, with largest reductions at safety-net hospitals. Findings showed that improvements in readmissions have not reversed following the implementation of HRRP. In contrast, disparities continue to persist at non-safety-net hospitals.
AHRQ-funded; HS023783.
Citation: Kaplan CM, Thompson MP, Waters TM .
How have 30-day readmission penalties affected racial disparities in readmissions?: an analysis from 2007 to 2014 in five US states.
J Gen Intern Med 2019 Jun;34(6):878-83. doi: 10.1007/s11606-019-04841-x..
Keywords: Hospital Readmissions, Racial and Ethnic Minorities, Hospitals, Medicare, Payment
Sheetz KH, Dimick JB, Regenbogen SE
How patient complexity and surgical approach influence episode-based payment models for colectomy.
This study looked into how the use of bundled payment programs would affect hospital reimbursements for colectomies. National data from the 100% Medicare Provider Analysis and Review files for the years 2010 to 2014 was used. Patients undergoing colectomies were identified using diagnosis-related group codes and ICD-9, Clinical Modification codes. Reconciliation payments were simulated as the difference between actual price-standardized 90-day episode payments and estimated regional spending benchmarks. The simulated bundled payment conditions showed 51.8% of hospitals would achieve shared savings, but the average case would incur reconciliation penalties. Laparoscopies would achieve the highest savings.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Dimick JB, Regenbogen SE .
How patient complexity and surgical approach influence episode-based payment models for colectomy.
Dis Colon Rectum 2019 Jun;62(6):739-46. doi: 10.1097/dcr.0000000000001372..
Keywords: Surgery, Payment, Healthcare Costs, Medicare, Hospitals
Diaz-Perez MJ, Hanover R, Sites E
Producing comparable cost and quality results from all-payer claims databases.
This study describes how all-payer claims databases (APCDs) can produce comparable cost and quality results for 4 states using a multistate analysis. Data was used from 2014 commercial claims in Colorado, Massachusetts, Oregon, and Utah. The partners standardized the rules for including payers, data set elements, measure specifications, SAS code and adjustments for population differences in age and gender. A Uniform Data Structure file format was created which can be used across multiple population, measures, and research dimensions.
AHRQ-funded; HS024072.
Citation: Diaz-Perez MJ, Hanover R, Sites E .
Producing comparable cost and quality results from all-payer claims databases.
Am J Manag Care 2019 May;25(5):e138-e44..
Keywords: Healthcare Costs, Payment, Quality of Care
Chukmaitov AS, Harless DW, Bazzoli GJ
Factors associated with hospital participation in Centers for Medicare and Medicaid Services' Accountable Care Organization programs.
The aim of this study was to assess the organizational and environmental characteristics associated with hospital participation in the Medicare Shared Savings Program (MSSP) and Pioneer Accountable Care Organizations (ACOs). The investigators found that hospital participation in both Centers for Medicare and Medicaid Services ACO programs was associated with prior experience with risk-based payments and care management programs, advanced health information technology, and location in higher-income and more competitive areas.
AHRQ-funded; HS023332.
Citation: Chukmaitov AS, Harless DW, Bazzoli GJ .
Factors associated with hospital participation in Centers for Medicare and Medicaid Services' Accountable Care Organization programs.
Health Care Manage Rev 2019 Apr/Jun;44(2):104-14. doi: 10.1097/hmr.0000000000000182..
Keywords: Payment, Medicare, Hospitals
Modi PK, Kaufman SR, Caram MV
Impact of Medicare office visit payment reform on urologic practices.
This study analyzed the impact of the 2019 Medicare Physician Fee Schedule on urologic practices. This new payment system modifies reimbursement for office evaluation and management visits. Researchers used a sample of 20% of National Medicare claims. They identified 2822 practices ranging from solo to multispecialty groups. Solo practices had the least benefit in reimbursement with most practices having a small increase in payment.
AHRQ-funded; HS025707.
Citation: Modi PK, Kaufman SR, Caram MV .
Impact of Medicare office visit payment reform on urologic practices.
Urology 2019 Apr;126:83-88. doi: 10.1016/j.urology.2019.01.013..
Keywords: Medicare, Ambulatory Care and Surgery, Payment, Policy
Damberg CL, Silverman M, Burgette L
Are value-based incentives driving behavior change to improve value?
The purpose of this study, which used semi-structured interviews and surveys, was to understand physician organization (PO) responses to financial incentives for quality and total cost of care among POs that were exposed to a statewide multipayer value-based payment (VBP) program, and to identify challenges that POs face in advancing the goals of VBP.
AHRQ-funded; HS024067.
Citation: Damberg CL, Silverman M, Burgette L .
Are value-based incentives driving behavior change to improve value?
Am J Manag Care 2019 Feb;25(2):e26-e32..
Keywords: Healthcare Costs, Payment
Markovitz AA, Hollingsworth JM, Ayanian JZ
Risk adjustment in Medicare ACO program deters coding increases but may lead ACOs to drop high-risk beneficiaries.
The purpose of this study was to examine whether beneficiaries' exposure to the Medicare Shared Savings Program (MSSP) was associated with changes in risk scores and whether risk scores were associated with entry to or exit from the MSSP. Findings indicate that MSSP was not associated with consistent changes in within-beneficiary risk scores, but that beneficiaries at the 95th percentile of risk score had a higher chance of exiting the MSSP when compared to beneficiaries at the 50th percentile. The researchers conclude that decision not to upwardly adjust risk scores in the MSSP has successfully deterred coding increases, but this might discourage accountable care organizations to care for high-risk beneficiaries.
AHRQ-funded; HS024525; HS024728; HS025615.
Citation: Markovitz AA, Hollingsworth JM, Ayanian JZ .
Risk adjustment in Medicare ACO program deters coding increases but may lead ACOs to drop high-risk beneficiaries.
Health Aff 2019 Feb;38(2):253-61. doi: 10.1377/hlthaff.2018.05407..
Keywords: Medicare, Payment