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Regulating Quality
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Governmental regulation has attempted to lower healthcare costs and improve quality. In the 1980s, diagnostically related groups (DRGs) shifted Medicare hospital payments from a cost-based system to a condition-based system. More recently, the Affordable Care Act (ACA) funded value-based purchasing initiatives through reductions in DRG payments. The ACA also established Accountable Care Organizations that must be willing to be accountable for the quality, cost, and overall care of Medicare beneficiaries in a “medical home” model. On the physician side, a Merit-Based Incentive Payment System is replacing the Sustainable Growth Rate formula. The effect of regulation may be uncertain, but further change seems inevitable.
Title: Regulating Quality
Description:
Governmental regulation has attempted to lower healthcare costs and improve quality.
In the 1980s, diagnostically related groups (DRGs) shifted Medicare hospital payments from a cost-based system to a condition-based system.
More recently, the Affordable Care Act (ACA) funded value-based purchasing initiatives through reductions in DRG payments.
The ACA also established Accountable Care Organizations that must be willing to be accountable for the quality, cost, and overall care of Medicare beneficiaries in a “medical home” model.
On the physician side, a Merit-Based Incentive Payment System is replacing the Sustainable Growth Rate formula.
The effect of regulation may be uncertain, but further change seems inevitable.
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