Linking performance to Medicare payments is unlikely to improve care, report says

BMJ 2013; 347 doi: (Published 26 July 2013) Cite this as: BMJ 2013;347:f4756
  1. Michael McCarthy
  1. 1Seattle

Adjusting Medicare payments based on geographic differences in performance as some US lawmakers have proposed would not improve healthcare, says a report from the US Institute of Medicine (IOM).1

The report was prepared in response to a provision of the 2010 Affordable Care Act that mandated that the institute assess whether adopting a “geographic value index” for Medicare payments would save money without harming the quality of care.

Such an index would use quality and cost data for regions to set Medicare payment rates that would encourage providers in regions where costs are higher and quality lower to match the performance of providers in regions where quality is higher …

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