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MACRAeconomics: Physician incentives and behavioral economics in the Medicare Access and CHIP Reauthorization Act

机译：Macraeconomics：医生激励和行为经济学在Medicare访问和筹码重新授权法案中

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On April 16, 2015, the Medicare Access & CHIP Reauthorization Act (MACRA) was signed into law. Motivated by a vision to move physician payment towards a more value-based system, this bipartisan legislation aims to establish the groundwork for advancing payment reform in traditional Medicare. MACRA's initial achievement is the repeal of the sustainable growth rate formula. Yet its more enduring, substantive contribution to payment reform will likely be found in its creation of the Quality Payment Program. The Quality Payment Program diverges from traditional fee-for-service payment in 2 ways: by building incentives for value explicitly into the fee schedule, and by enhancing incentives for providers to enter payment models involving financial risk with both Medicare and other payers. The two strategies are embedded in distinct payment models. Providers are free to choose their path. In Spring of 2016, the Centers for Medicare and Medicaid Services published the proposed rule for the Quality Payment Program, containing specific details of policies for public comment. This article provides an overview of the Quality Payment Program and introduces the present theme issue of Healthcare: the Journal of Delivery Science and Innovation focused on applications of behavioral economics to physician incentives. Broadly, behavioral economics may impact provider behavior directly through the incentives within MACRA. It may also exert its impact through the design of internal incentives by physician organizations under population-based payment arrangements, which MACRA encourages. The articles in this issue explore these factors and others, with an emphasis on lessons from the implementation of incentives designed to encourage high-value care.
机译：2015年4月16日，Medicare Access＆Chip Reawrorization Act（Macra）签署了法律。这项比普索坦立法旨在使医生支付给予更具价值的制度，旨在为推进传统医疗保险的支付改革建立奠基。 Macra的初步成就是废除可持续增长率公式。然而，它更加持久地，对支付改革的实质性贡献可能会在其创造质量付款方案中找到。质量支付计划在2种方式中发出传统的服务费用：通过明确建立价值的奖励，并通过加强供应商的激励措施，进入涉及医疗保险和其他付款人的金融风险的付款模式。两种策略嵌入了不同的付款模式。提供商可以自由选择他们的道路。 2016年春季，医疗保险和医疗补助服务的中心公布了拟议的质量支付计划规则，其中包含公众评论的具体政策细节。本文概述了质量付款方案，并介绍了本医疗保健的主题问题：交付科学与创新杂志的重点是行为经济学在医生激励措施中的应用。广泛地，行为经济学可能会通过Macra内的激励措施影响提供者行为。在Macra鼓励的基于人口的支付安排下，它也可能通过医师组织的内部激励设计来施加其影响。本问题的文章探讨了这些因素和其他因素，重点是旨在鼓励高价值护理的激励措施的课程。

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