The Many Attempts to Improve the Value of Medicare

by birtanpublished on September 9, 2020

A period of innovation meant to make Medicare more value-based has had some successes but perhaps not as many as we might have liked that's the topic of this week's healthcare triage special thanks to austin frac from who's upshot column this episode was a depth for most

Of its history medicare paid for health care in ways that encouraged more services whether they improved health or not critics called it an emphasis on volume not value the Affordable Care Act was intended to change that Medicare

Started a number of programs to do so including several new ones this year nearly a decade after passage of the ACA is value-based payment working the Obama administration's goal was for 90 percent of Medicare payments to hospitals and

Doctors to be tied to measures of quality by 2018 although distancing itself from specific targets the Trump administration has also committed to this goal according to the health care payment learning and Action Network

Medicare's 90% value-based goal has been acheived that sounds like mission accomplished but it's not as simple as that different programs have different notions of value Medicare's hospital readmissions

Reduction program established in 2010 penalizes hospitals that have high rates of readmissions for certain illnesses although hospitals can lose only up to 3% of payment a hundred percent of their payment is considered tied to value the

Key is whether programs like this improve health care quality or reduce health care spending the hospital readmissions reduction program has been extensively examined we studies drawing different conclusions initial analyses

Of the program suggested is responsible for reducing hospital readmissions saving Medicare billions of dollars a year but some later studies found that these reports of success were overstated among other concerns some studies found

That reduced hospital readmissions were associated with increased risk of death though not all studies agree on this point and experts disagree on the value of the program what is clear is that the program has had a smaller impact on

Hospital readmissions than originally thought perhaps reducing them by as little as one third of a percentage point another Medicare value-based payment program is considerably more brought the hospital value-based

Purchasing program was introduced in 2011 and rewards or penalizes hospitals based on mortality infection rates patient experience and safety cost and other measures of quality 20 at all typical bonuses or penalties are a

Fraction of 1% of a hospital's total medical payments a study published in health services research compared about 2,800 hospitals in the program with about 300 exempt from the study found no effect from financial incentives of the

Program on quality of care or patient satisfaction but the study included data only up to 9 months after the program struck and it may take hospitals longer to make measurable changes it also may not another study published in BMJ

Looked at outcomes two and a half years after the start of the hospital value-based purchasing program it found no differences in changes and mortality rates between hospitals in the program versus those exempt from it and another

Study published in Health Affairs found no evidence that the program improved patient satisfaction up to 3 years after implementation Medicare has achieved greater success with programs that have raised mistakes one's gonna put

Hospitals and healthcare organizations at greater risk of financial loss or have offered prospects for larger financial gain one popular approach called bundled payments pays health providers one amount for all of the care

For a certain condition within a certain period like 90 days for hip replacement care there is evidence that some of these programs can save money without reductions in quality although design details matter

Another approach accountable care organizations also take many forms what they have in common is that they offer healthcare organizations the chance to earn bonuses for accepting some financial risk provided they meet a set

Of quality targets many studies of accountable care organizations or a COS have found that they reduce spending with no quality degradation so overall is Medicare moving towards higher value experts agreed that results have been

Quite a bit more modest than expected but some emphasize that even small successes are important to future improvements paying for health care value is a popular slogan but Medicare is still figuring out

How to do it Paige enjoy this video you might enjoy this other video on what does Medicare really cover we'd also really appreciate it if you'd like the episode and subscribe down below and another good way to support the show is

At patreon.com slash healthcare triage our surgeon Admiral Sam does and so does our research associate Joe sevens and they're cool

Related Videos

hey guys techrax here coming at you guys with another giveaway this is gonna be an iPhone 5s two of these brand new phones not the one in this video guys this i...
hey guy there's a popular game in the app store called flappy bird right now and it's supposedly really annoying believe it or not I haven't played ...
hey guys tech Rex here so right here with me I have an Apple iPhone 5s this is the gold one I also have with me some liquid nitrogen yes this is the real deal a...
hey guys techrax here right here I have the iPhone 5s with me this is the champagne or the gold color I still can't really figure out if it's champagne ...
hey guys tear cracks here so this video really exciting video I have the new Samsung Galaxy s5 for you guys this is the long-awaited cellular devices releases i...
everyone techrax here in this video I've got the latest Samsung Galaxy s5 right here as well as the Apple iPhone 5s and we're going to be doing a simple...
everyone techrax here in this video guys have a really exciting device this is the Samsung Galaxy s5 charcoal black and I'm really liking I after seeing the...
everyone techrax here here with me off the Samsung Galaxy s5 this is a perfectly fine s5 it is cracked from the drop test that I had with also one minor neck as...
hey guys tetrax here so in this video I'm going to try and burn the newly released Samsung Galaxy s5 this is the shimmering white 16 gigabyte model and if y...
everyone techrax here so I got my burn Samsung Galaxy s5 and I wanted to see whether the heartbeat sensor would still work the heart monitor on your galaxy s5 a...
hey guys Tech Rex here so I'm really excited to bring you guys a giveaway for my channel but this time I'm actually teaming up with a buddy of mine your...
hey guys techrax here so in this video I'm going to be hopefully instructing you guys how to make your very own a tech sandwich slash burger slash meal so y...
hey guys techrax here so I've got a galaxy s5 here this is the copper gold hopefully you guys can see pretty well it is sunset so it's getting a little ...
hey guys techrax here so right here with me I have a professional deep fryer in here is already some canola or corn or whatever oil I don't know vegetable o...
hey guys techrax here so just trying to make this video short and quick i'm having recently i got five hundred thousand subscribers and yeah most of you guy...
hey guys texture so in this video I have a drop test on the latest LG g3 device now this is actually the gold-coloured LG g3 this has not been released in the U...
hey guys techrax here so in this video we'll teach you guys how to make your iPhone indestructible this is essentially a case that's been around for yea...
hey guys techrax here soon in this video we had a train run over the iPhone 5s so we actually did this in two different instances initially we had a Space Gray ...
hey guys tech cracks here so in this video we're going to be dropped testing the newly released Amazon fire phone this is exclusive for AT&T and I belie...
hey guys techrax here so right here with me I have the Amazon fire phone this is the one I dropped and you know I thought what better what else do I do with thi...