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Roadmap for Implementing Value Driven Healthcare in the Traditional Medicare Fee-for-Service Program

机译:在传统医疗保险按服务计划中实施价值驱动型医疗保健的路线图

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Given that CMS policies have a transformative impact on the health care system, it is important to develop the tools necessary to create rational approaches to lessen healthcare cost growth and to identify and encourage care delivery patterns that are not only high quality, but also cost-efficient. To help address these concerns, CMS during the current Administration and with direction from Congress (e.g., through enactment of provisions in the Medicare Modernization Act, Deficit Reduction Act, and other provisions) has begun to transform itself from a passive payer of services into an active purchaser of higher quality, affordable care. Further future efforts to link payment to the quality and efficiency of care provided, would shift Medicare away from paying providers based solely on their volume of services. The catalyst for such change would be grounded in the creation of appropriate incentives encouraging all healthcare providers to deliver higher quality care at lower total costs. This is the underlying principle of value-based purchasing (VBP). The cornerstones of VBP are the development of a broad array of consensus-based clinical measures, effective resource utilization measurement, and the payment system redesign mentioned above.

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