Medicare's Stewardship Role to Improve Care Delivery: Opportunities for the Biden Administration.
J Health Polit Policy Law
; 46(4): 627-639, 2021 08 01.
Article
in English
| MEDLINE | ID: covidwho-1045578
ABSTRACT
Medicare initiatives have been instrumental in improving care delivery and payment as exemplified by its role in broadly expanding the use of telehealth during the COVID-19 pandemic. Medicare innovations have been adopted or adapted in Medicaid and by private payers, while Medicare Advantage plans successfully compete with traditional Medicare only because their payment rates are tied by regulation to those in the traditional Medicare program. However, Medicare has not succeeded in implementing new, value-based payment approaches that also would serve as models for other payers, nor has Medicare succeeded in improving quality by relying on public reporting of measured performance. It is increasingly clear that burdensome attention to measurement and reporting distracts from what could be successful efforts to actually improve care through quality improvement programs, with Medicare leading in partnership with providers, other payers, and patients. Although Congress is unlikely to adopt President Biden's proposals to decrease the eligibility age for Medicare or to adopt a public option based on Medicare prices and payment methods in the marketplaces, the Biden administration has an opportunity to provide overdue, strategic direction to the pursuit of value-based payments and to replace failed pay-for-performance with provider-managed projects to improve quality and reduce health disparities.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Reimbursement Mechanisms
/
Medicare
/
Delivery of Health Care
/
Quality Improvement
/
Health Policy
Type of study:
Prognostic study
/
Qualitative research
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
J Health Polit Policy Law
Year:
2021
Document Type:
Article
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