Issue Brief

No. 852

Seeking Value in Medicare: Performance Measurement for Clinical Professionals
October 30, 2013

Author

Lisa Sprague, MBA

Summary

The Medicare program, despite its reputation of being a bill payer with little regard to the worth of the services it buys, has begun to put in place a range of programs aimed at assessing quality and value, with more to come. Attention to resource use and cost is nascent. The issues are complex, and it is no surprise that there is a level of contention between providers and regulators, even though both profess commitment to improved quality. This paper summarizes the quality and value programs that apply to physicians and other clinical professionals, as well as programs designed to encourage the adoption of technology to support quality improvement. Participation in all is voluntary. However, a decision not to participate increasingly carries a financial penalty, as Congress (and, by extension, the U.S. Department of Health and Human Services, or HHS) tries to encourage behavior it cannot force.

Related Materials

Robert A. Berenson, Peter J. Pronovost, and Harlan M. Krumholz, "Timely Analysis of Immediate Health Policy Issues: Achieving the Potential of Health Care Performance Measures," Robert Wood Johnson Foundation and the Urban Institute, May 2013, p. 1.

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