Fostering Medicare--Private Collaboration in Value-Based Purchasing


Medicare and private purchasers have both adopted innovations to constrain costs and ensure they are receiving good value for their health care dollar. Medicare, the nation's largest health care purchaser, uses electronic claims processing and prospective payment systems for most types of health care providers. Many private purchasers, meanwhile, have implemented disease and care management programs. But the two sectors have rarely tried to work together, learn from each other, and leverage one another's efforts. This project seeks to identify and foster value-based purchasing activities that could be implemented by Medicare and private purchasers. In advisory group meetings and interviews with a variety of experts, the investigators will focus primarily on three approaches: 1) provider-based information technology, to manage administrative and clinical information; 2) multipayer claims databases, to identify efficient, high-quality providers; and 3) paying for performance.

Grant Details

Grantee Organization:
Urban Institute
Principal Investigator:
Robert A. Berenson, M.D.
Award Amount:
Approval Date:
April 13, 2004

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