Medicare's Value-Based Payment Modifier program inadvertently shifted money away from physicians who treated sicker, poorer patients to pay for bonuses that rewarded practices treating richer, healthier populations, according to a study this week in Annals of Internal Medicine.
In addition, components from that failed pay-for-performance prototype that do not account for patient demographics remain its successor program, and could scuttle its chances for success, researchers said.
"As long as these programs do not account adequately for patient differences, which is very difficult to do, they will further deprive practices serving low-income populations of important resources," said Eric Roberts, assistant professor of health policy and management at the University of Pittsburgh Graduate School of Public Health and lead author of the study.
The research suggests that the Value Modifier may have hit a trifecta of failure. It did not reduce the cost of care, nor improve the quality of the care, nor improve the health of the patients. In fact, it may have made things worse.