Publications: Payment Reform

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How Health Reform Legislation Will Affect Medicare Beneficiaries

March 17, 2010 - This issue brief examines the provisions in the pending legislation and how each one would work to improve benefits, extend the fiscal solvency of the Medicare Hospital Insurance Trust Fund, reduce pressure on the federal budget, and contribute to moving the health care system toward better access to care.

Issue Brief

Measurement Framework: Evaluating Efficiency Across Patient-Focused Episodes of Care

March 5, 2010 - This consensus report lays the groundwork for a measurement framework that evaluates efficiency, and ultimately value, across patient-focused episodes of care. This framework will help key stakeholders move toward a high-performing healthcare system that is patient-centered, focused on quality, mindful of costs, and vigilant against waste.

Literature Abstract

Medicare Savings Programs: Analyzing Options for Expanding Eligibility

February 25, 2010 - Medicare savings programs are designed to provide financial assistance to Medicare beneficiaries whose income and assets are too high to allow them to qualify for full Medicaid coverage. This article examines policy changes that would expand eligibility by either relaxing resource requirements or increasing the income limit.

In the Literature

The Potential of Global Payment: Insights from the Field

February 18, 2010 - Increasing awareness of cost and quality problems caused by the prevailing fee-for-service payment system has led to a reemergence of interest in global payment. This project interviewed and surveyed physician leaders of small and large organizations to glean insights into global payment successes and failures.

Fund Report

Getting from Here to There in Payment Reform: Necessary Practices and Policies

February 1, 2010 - Successful health reform hinges not only on improving coverage and access to care, but also on delivery system and payment reform, argue The Commonwealth Fund’s Stuart Guterman and Stephen C. Schoenbaum, M.D., in the Journal of Ambulatory Care Management.

Literature Abstract

Medicare Advantage Reforms: Comparing House and Senate Bills

December 21, 2009 - This Commonwealth Fund issue brief compares approaches to reducing Medicare Advantage payments and other provisions in the House and Senate bills that aim to improve the value that Medicare obtains for the dollars it spends.

Issue Brief

Quality-Based Payment for Medical Groups and Individual Physicians

December 11, 2009 - This Commonwealth Fund-supported study in Inquiry shows that medical groups that receive bonuses for attaining certain levels of quality and patient satisfaction are more likely than other groups to offer similar incentives to their physicians.

In the Literature

Health Care Opinion Leaders Views on Medicare Reform

November 2, 2009 - In the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders survey, experts in health care and health policy say they favor strengthening Medicare's ability to help control program costs and support broader health system reform.

Data Brief

State Hospital Rate-Setting Revisited

October 27, 2009 - In an attempt to control rapid growth in hospital costs, beginning in the mid-1970s seven states implemented rate-setting programs to regulate hospital payments. Although all but two have since been discontinued, these states' experiences offer lessons for policymakers as they continue searching for ways to control rising health care costs.

Issue Brief

Finding Resources for Health Reform and Bending the Health Care Cost Curve

July 2, 2009 - This Fund report examines policy options that could slow growth in health spending, improve health outcomes, and provide additional revenues to finance comprehensive reform.

Fund Report

The Continuing Cost of Privatization: Extra Payments to Medicare Advantage Plans Jump to $11.4 Billion in 2009

May 4, 2009 - The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, MA plans have, for the past six years, been paid more for their enrollees than they would be expected to cost in traditional fee-for-service Medicare.

Issue Brief

Health Care Opinion Leaders Views on Slowing the Growth of Health Care Costs

April 27, 2009 - Nearly all respondents to the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey agree that the U.S. must rein in the growth of health care spending, and most believe it is possible to hold the current percentage of gross domestic product (GDP) devoted to health care steady over the next decade. In addition, large majorities expressed support for a range of strategies to reduce costs, including many of those outlined in President Obama’s budget blueprint.

Data Brief

Using Medicare Payment Policy to Transform the Health System: A Framework for Improving Performance

January 27, 2009 - By using payment incentives, Medicare, the nation's largest health care payer, could lead the United States to higher health system performance and yield great benefits, say Fund staff and colleagues in this Health Affairs article.

In the Literature