Payment reform highlighted in special journal issue
Research Activities, April 2011, No. 368
The Affordable Care Act was signed into law on March 23, 2010. A key feature of this health care reform legislation is the realization that changes in the payment system must be part of the solution. A theme issue on payment reform in the December 2010 journal HSR: Health Services Research 45(6 Part II) presents key research in an area that will undoubtedly be of critical importance as the nation gears up to implement one of the largest American health reform initiatives in history. Specifically, the theme issue, sponsored by the Agency for Healthcare Research and Quality, focuses on four major challenges to payment reform:
- Structuring payment bundles that reduce regional variation without hurting quality.
- Selecting performance measures that really measure performance.
- Fine-tuning pay-for-performance models.
- Factoring in external market factors.
The issue begins with an introduction by Irene Fraser, Ph.D., and William Encinosa, Ph.D., of AHRQ's Center for Delivery, Organization, and Markets, and Laurence Baker, Ph.D., of Stanford University. They discuss the issue's seven papers that provide new evidence on one or more of the challenges involved with payment reform. The papers reveal that creating payment systems that truly work to improve value and quality will require a sophisticated and nuanced approach.
Two studies, Chien, A. T., Li, Z., and Rosenthal, M. B. "Improving timely childhood immunizations through pay for performance in Medicaid-managed care." (HS17146), pp. 1934-1947; and Yu, H. and Dick, A. W. "Risk-adjusted capitation rates for children: How useful are the survey-based measures?" (HS16742), pp. 1948-1962, were funded by the Agency for Healthcare Research and Quality. Reprints of the Introduction (AHRQ Publication No. 11-R027) are available from the AHRQ Publications Clearinghouse.