Association Between Patient Cognitive and Functional Status and Medicare Total Annual Cost of Care: Implications for Value-Based Payment

JAMA Internal Medicine
Kenton J JohnstonKaren E Joynt Maddox

Abstract

Medicare is moving toward value-based payment. The Merit-Based Incentive Payment System (MIPS) program judges outpatient clinicians' performance on a measure of annual Medicare spending. However, this measure may disadvantage outpatient clinicians who care for vulnerable populations because the algorithm omits meaningful determinants of cost. To determine whether factors not included in Medicare risk adjustment, including patient neuropsychological and functional status, as well as local area health resources and economic conditions, are associated with Medicare total annual cost of care (TACC), and evaluate whether accounting for these factors is associated with improved TACC performance by outpatient safety-net clinicians. In this retrospective observational study, we used the Medicare Current Beneficiary Survey (MCBS) to examine patient-reported neuropsychological and functional status and the Area Health Resources File to obtain information on local area characteristics. Included were Medicare beneficiaries with annual physician or clinic visits to outpatient safety-net (federally qualified health centers and rural health clinics) and non-safety-net clinics, contributing 76 927 person-years of data to the MCBS from 2006 thr...Continue Reading

References

Oct 19, 2006·Journal of the American College of Cardiology·Thomas RutledgePaul J Mills
Feb 28, 2007·Archives of Internal Medicine·Andrew SherwoodAlan L Hinderliter
May 5, 2012·Psychiatric Services : a Journal of the American Psychiatric Association·Justin K BenzerJames F Burgess
Jun 20, 2012·Annals of Internal Medicine·Tamara G FongSharon K Inouye
Mar 26, 2014·Archives of Gerontology and Geriatrics·Lori A DaielloStefan Gravenstein
Aug 21, 2014·Journal of Psychosomatic Research·Dimitry S DavydowWayne J Katon
Dec 2, 2014·Annals of Internal Medicine·Amy J H KindMaureen Smith
Feb 3, 2015·JAMA Internal Medicine·S Ryan GreysenKenneth E Covinsky
Jun 4, 2015·Psychiatric Services : a Journal of the American Psychiatric Association·Emma Elizabeth McGinty, Srinivas Sridhara
Sep 15, 2015·JAMA Internal Medicine·Michael L BarnettJ Michael McWilliams
Nov 3, 2016·The New England Journal of Medicine·Dave A ChokshiRoss M Wilson
Dec 5, 2016·Healthcare : the Journal of Delivery Science and Innovation·Karen E JoyntAshish K Jha
Dec 29, 2016·The New England Journal of Medicine·Karen E JoyntArnold M Epstein
Feb 9, 2017·The New England Journal of Medicine·Melinda B Buntin, John Z Ayanian
Aug 8, 2017·JAMA Internal Medicine·Arlene S AshMelissa A Clark
Aug 8, 2017·JAMA Internal Medicine·Karen E Joynt Maddox

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Citations

May 11, 2019·Journal of the American Geriatrics Society·Bruce LeffChristine S Ritchie
Sep 22, 2019·Current Psychiatry Reports·Aaron Samuel BreslowBenjamin Lê Cook
Dec 28, 2019·Journal of the American Geriatrics Society·Kenton J JohnstonKaren E Joynt Maddox
Jan 31, 2020·JAMA : the Journal of the American Medical Association·Kenton J JohnstonKaren E Joynt Maddox
Dec 19, 2019·Journal of the American Geriatrics Society·Andrew C QiKaren E Joynt Maddox
Apr 7, 2020·Annals of Internal Medicine·Kenton J JohnstonKaren E Joynt Maddox
Jun 3, 2020·JAMA Network Open·Thomas M GillTerrence E Murphy
Sep 9, 2020·JAMA : the Journal of the American Medical Association·Kenton J JohnstonKaren E Joynt Maddox
Aug 15, 2020·Frontiers in Public Health·Aarón Salinas-RodríguezJulio Cesar Montañez-Hernández
Aug 28, 2020·Annals of Physical and Rehabilitation Medicine·Eleonore BayenKatherine L Possin
Mar 7, 2021·Journal of the American Geriatrics Society·Stephanie NothelleCynthia Boyd
May 8, 2021·Journal of the American Geriatrics Society·Kerry M SheetsKristine E Ensrud
Jul 28, 2021·Journal of the American Geriatrics Society·Sarah L SzantonLaura N Gitlin
Jan 4, 2022·Annals of Internal Medicine·Jacob WallaceChima D Ndumele

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