CMS' Value-Based Payment Modifier program, which sought to improve care value by transitioning away from fee-for-service models to value-based care, inadvertently shifted money away from physicians who treat poorer and sicker patient populations, according to a study published in the Annals of Internal Medicine.
For the study, researchers assessed Medicare spending rates and quality performance among clinicians that took part in the CMS program between 2013 and 2016. Researchers compared these variables to clinicians who did not participate in the program. Quality measures assessed in the study included mortality rates and 30-day readmissions.
While researchers found no evidence the program improved care quality with its reimbursement incentives, they did determine the program funneled money away from physicians who treated sicker, poorer patients to fund bonuses for physicians treating more affluent, healthier populations.
"As long as these programs do not account adequately for patient differences, which is very difficult to do, they will further deprive practices serving low-income populations of important resources," said Eric Roberts, PhD, assistant professor of health policy and management at the University of Pittsburgh Graduate School of Public Health and lead author of the study.
Researchers questioned whether the successor to the 2013-16 CMS program — the Merit-based Incentive Payment System, which took effect in January — will yield different results.
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