Financial Incentives and Physician Practice Participation in Medicare's Value‐Based Reforms

Markovitz, Adam A.; Ramsay, Patricia P.; Shortell, Stephen M.; Ryan, Andrew M.

doi:10.1111/1475-6773.12743

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…3,6 As Medicare and other payers introduce an array of innovation programs and alternative payment models, 19 practices previously engaged in such efforts may be more likely to take on new innovations in general. 20 This finding raises the possibility of widening gaps between practices that engage in innovation programs and those that do not.…”

Section: Discussionmentioning

confidence: 99%

Practices Caring For The Underserved Are Less Likely To Adopt Medicare’s Annual Wellness Visit

et al. 2018

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In 2011 Medicare introduced the annual wellness visit to help address the health risks of aging adults. The visit also offers primary care practices an opportunity to generate revenue, and may allow practices in accountable care organizations to attract healthier patients while stabilizing patient-practitioner assignments. However, uptake of the visit has been uneven. Using national Medicare data for the period 2008-15, we assessed practices' ability and motivation to adopt the visit. In 2015, 51.2 percent of practices provided no annual wellness visits (nonadopters), while 23.1 percent provided visits to at least a quarter of their eligible beneficiaries (adopters). Adopters replaced problem-based visits with annual wellness visits and saw increases in primary care revenue. Compared to nonadopters, adopters had more stable patient assignment and a slightly healthier patient mix. At the same time, visit rates were lower among practices caring for underserved populations (for example, racial minorities and those dually enrolled in Medicaid), potentially worsening disparities. Policy makers should consider ways to encourage uptake of the visit or other mechanisms to promote preventive care in underserved populations and the practices that serve them.

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Section: Discussionmentioning

confidence: 99%

Practices Caring For The Underserved Are Less Likely To Adopt Medicare’s Annual Wellness Visit

et al. 2018

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“…In addition to ACO participation being a determinant of health IT use, past experiences with various policies may also influence the relationship. A study of physician practices considered ACOs’ past experience with financial incentives and public reporting requirements as indicators of the organization’s preparedness for participation in value-based reform efforts such as ACOs [38]. Practices participating in ACOs with prior exposure to public reporting requirements were more likely to be prepared to implement Meaningful Use (MU, a policy incentivizing the use of health IT).…”

Section: Resultsmentioning

confidence: 99%

“…Several institutional funding mechanisms were also present. Lastly, of the 33 studies reviewed, 14 used either a traditional organizational theory [1724272831], early ACO frameworks or findings [2021223037], or other policy or health frameworks [253843] as a theoretical or conceptual framework. While there are some examples of multiple studies using the same theory or framework, there is generally a lack of repetition of frameworks used in this field, further contributing to the heterogeneity of work in this area.…”

Section: Resultsmentioning

confidence: 99%

Health Information Technology and Accountable Care Organizations: A Systematic Review and Future Directions

Balio

Apathy

Danek

2019

eGEMs

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Background: Since the inception of Accountable Care Organizations (ACOs), many have acknowledged the potential synergy between ACOs and health information technology (IT) in meeting quality and cost goals. Objective: We conducted a systematic review of the literature in order to describe what research has been conducted at the intersection of health IT and ACOs and identify directions for future research. Methods: We identified empirical studies discussing the use of health IT via PubMed search with subsequent snowball reference review. The type of health IT, how health IT was included in the study, use of theory, population, and findings were extracted from each study. Results: Our search resulted in 32 studies describing the intersection of health IT and ACOs, mainly in the form of electronic health records and health information exchange. Studies were divided into three streams by purpose; those that considered health IT as a factor for ACO participation, health IT use by current ACOs, and ACO performance as a function of health IT capabilities. Although most studies found a positive association between health IT and ACO participation, studies that address the performance of ACOs in terms of their health IT capabilities show more mixed results. Conclusions: In order to better understand this emerging relationship between health IT and ACO performance, we propose future research should consider more quasi-experimental studies, the use of theory, and merging health, quality, cost, and health IT use data across ACO member organizations.

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“…Similarly, Izguttinov et al [27] found that physicians identified education and physician/staff training influenced physician behavior change as new payment models evolve. Existing research also showed that physicians/physician practices with prior performance incentives and public reporting experience were more likely to have a positive attitude toward P4P program compliance and elect to participate in new programs [28] , [5] . This study confirms findings from the existing body of literature demonstrating that physician knowledge of P4P program design and impact on patient outcomes influences physician attitudes.…”

Section: Discussionmentioning

confidence: 99%

Physician descriptions of the influence of pay for performance on medical decision-making

Graefe

Markette

2021

Health Policy OPEN

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Financial Incentives and Physician Practice Participation in Medicare's Value‐Based Reforms

Cited by 6 publications

References 26 publications

Practices Caring For The Underserved Are Less Likely To Adopt Medicare’s Annual Wellness Visit

Practices Caring For The Underserved Are Less Likely To Adopt Medicare’s Annual Wellness Visit

Health Information Technology and Accountable Care Organizations: A Systematic Review and Future Directions

Physician descriptions of the influence of pay for performance on medical decision-making

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