A prototype Medicare program designed to improve value of care by paying more to physicians who perform better on measures of health care quality and spending has failed to deliver on its central promise and, in the process, likely exacerbated disparities in health care delivery, according to findings of a study published Nov. 27 in Annals of Internal Medicine.
The Value-Based Payment Modifier program, which ran between 2013 and 2016, inadvertently shifted money away from physicians who treated sicker, poorer patients to pay for bonuses that rewarded practices treating richer, healthier populations. This unintended consequence stems from the program’s failure to properly account for differences across various patient populations in clinical and social risk factors for poor outcomes, the researchers note.
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The researchers say that these findings bode ill for the program’s successor — launched in early 2017 — because its basic design is similar to the failed, earlier iteration of the model.