Paying physicians on the basis of the quality of their care, not the quantity, sounded like a good idea when Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which changed the way the government pays physicians.
For more than a decade, Medicare had paid physicians based on the number of services they provided to fee-for-service beneficiaries, whether or not those services were needed. Under MACRA, however, Medicare would assess the quality, value, and results of care physicians provided to these beneficiaries and reward the top performers while penalizing the worst.
Rubin R. How Value-Based Medicare Payments Exacerbate Health Care Disparities. JAMA. 2018;319(10):968–970. doi:10.1001/jama.2018.0240
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