Accounting for social risk factors in medicare payment : identifying social risk factors / Committee on Accounting for Socioeconomic Status in Medicare Payment Programs, Board on Population Health and Public Health Practice, Board on Health Care Services, Institute of Medicine, the National Academies of Sciences, Engineering, Medicine.

"A report of the National Academies of Sciences, Engineering, Medicine."

Includes bibliographies and index.

Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver. Accounting For Social Risk Factors in Medicare Payment is the fifth and final report in a series of brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report aims to put the entire series in context and offers additional thoughts about how to best consider the various methods for accounting for social risk factors, as well as next steps.

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This activity was supported by Contract No. HHSP233201400020B from the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

Introduction -- Social risk factors: definitions and data -- Methods to account for social risk factors -- Moving forward -- Appendix A: Identifying social risk factors -- Appendix B: Systems practices for the care of socially at-risk populations -- Appendix C: Summary -- Appendix D: Data -- Appendix E: Prior conclusions and recommendations -- Appendix F: Committee biosketches -- Index.