Payment Models

We evaluated both the Center for Medicare and Medicaid Services Innovation Center (CMS Innovation Center) models and the Medicare Shared Savings Program (MSSP) and found that they have generated gross savings for all beneficiaries in the Traditional Medicare program while demonstrating positive impacts on selected quality measures.

This ASPE issue brief lays out a proposed comprehensive analytic framework to fully evaluate the impact of the CMS Innovation Center’s efforts on the Medicare program and the broader health care system as a whole to test innovative payment and service delivery models that reduce program expenditures while preserving or enhancing the quality of care.

Improving health equity in the United States is a priority for the Biden-Harris Administration in order to address longstanding disparities in health outcomes. Health inequities can be conceptualized and measured as drivers of differences in health outcomes.

Payers across the health care spectrum have begun transitioning from paying for quantity toward paying for quality. These value-based payment (VBP) programs vary in scope and focus, but generally share the goals of improving cost-savings and linking payments to value rather than volume.

Dual eligible beneficiaries are an important subset of the Medicare and Medicaid populations because they have a high prevalence of chronic conditions and disabilities, substantial care needs, and high health care and long-term services and supports (LTSS) utilization and costs.

Link to Printer Friendly Version in PDF Format (5 PDF pages)

Michelle Dougherty and Margaret Williams AHIMA Foundation Michael Millenson Health Quality Advisors LLC Jennie Harvell U.S. Department of Health and Human Services June 2013  

U.S. Department of Health and Human Services