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Member Research & Reports

Member Research & Reports

Emory: Authors Call for New Culture of Shared Accountability for Medicare’s Merit-based Incentive Payment System

Dr. Adam S. Wilk, assistant professor of health policy and management at the Emory Rollins School of Public Health, is first author on an article published in The American Journal of Accountable Care that argues Medicare’s Merit-based Incentive Payment System gives too little consideration to the impact of social determinants of health on population health outcomes. Dr. Sanjula Jain, of The Health Management Academy, is a co-author on the paper.

The authors write the fact that individual providers are being held accountable for population-level health outcomes over which they have limited control has been underappreciated by the policy makers formulating Medicare’s value-based payment systems. This has resulted in a misalignment of accountability and capability that defers population health improvements.

“Everyone aspires to well-coordinated, population health-oriented systems of care in our communities,” says Dr. Wilk. “But we are asking a lot of individual clinicians or even most larger provider organizations when we hold them accountable for improving outcomes that can only really be addressed through well-implemented public health and social services programs. Some of the payment reform initiatives underway underappreciate the scope of the interventions needed to improve population health.”

Using the examples of major depressive disorder and antidepressant medication management as a lens, the authors write that payment reform efforts are too imprecise to drive significant improvements in population health care delivery when health care providers act independently.

Full article