Abstract
As Medicare expands its new payment programs, more patients will be treated by different providers participating in different payment models. Such overlaps make evaluation of outcomes difficult and create financial distortions that may undermine the models' goals.
Since 2012, the Center for Medicare and Medicaid Services (CMS) has introduced more than a dozen new Medicare payment models. Most of them emanate from the Center for Medicare and Medicaid Innovation (CMMI), whose strategy is to launch various initiatives, evaluate them rapidly, and expand those that reduce spending without harming quality of care.
1
Accountable care organization (ACO), bundled-payment, and patient-centered medical home models currently account for most of the spending in these initiatives, many of which have grown quickly. By 2016, a total of 8.9 million seniors were attributed to Medicare Shared Savings, Pioneer, or Next Generation ACOs, accounting . . .