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1、CORPORATIONEffectsofHealthCarePaymentModelsonPhysicianPracticeintheUnitedStatesFOLLOW-UPSTUDYMarkW.Friedberg,PeggyG.Chen,MollySimmons,TisamarieSherry,PeterMendel,LauraRaaen,JamieRyan,PatrickOrr,CarolVargo,LindseyCarlasare,ChristopherBotts,KathleenBlakeIn2014,RANDandtheAmericanMedicalAssocia
2、tion(AMA)conductedaqualitativeresearchprojectentitled“EffectsofHealthCarePaymentModelsonPhysicianPracticeintheUnitedStates”thatdescribedhowalternativepaymentmodelssuchascapitation,episode-basedandbundledpayment,sharedsavings,andpayforperformanceaffectedmultipleaspectsofphysicianpractice.Sin
3、ce2014,alternativepaymentmodelshaveexpandedtoincludenewprivate,state,andfederalprograms—mostnotablytheMedicareAccessandCHIPReautho-rizationActof2015(MACRA)QualityPaymentProgram.Theprojectwereportonhereupdatesour2014studywithqualitativedatafromphy-sicianpracticeleaders,frontlinephysicians,an
4、dotherobserversinthesamesixmarketsweexaminedin2014.Wheneverpossible,were-interviewedthesameindividualswhopartici-patedinthe2014study.Thisallowedustodescribehowtheirexperienceswithpreexistingandnewalternativepaymentmodelshadevolvedoverafour-yearperiod.ThecurrentprojectbeganonOctober18,2017,a
5、ndwascompletedonOctober24,2018.ProjectfindingsareintendedtohelpguideeffortsbytheAMAandotherstakeholderstoimprovecurrentandfuturealternativepaymentprogramsandhelpphysicianpracticessucceedinamorevalue-drivenenvironment.ThisworkwassponsoredbytheAMA.Theopinionsexpressedinthisreportarethoseofthe
6、authorsandcannotbeinterpretedasAMApolicy.TheresearchwasconductedbyRANDHealth,adivisionoftheRANDCorporation.AprofileofRANDHealth,abstractsofpubli-cations,andorderinginformationcanbefoundatwww.rand.org/health.iiiviEffectsofHealthCarePaymentModelsonPhysicianPracticeintheUnitedStatesviEffectsof
7、HealthCarePaymentModelsonPhysicianPracticeintheUnitedStatesPrefaceiiiTablesixSummaryxiAcknowledgmentsxviiAbbreviationsxixIntroduction1OrganizationofThisReport1LiteratureUpdate:EffectsofPaymentModelsonPhysicianPractices3Overview3PaymentModelsIncludedinthe
