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CMS value-based payment models underrepresent Black, Hispanic, dual-eligible, and disadvantaged Medicare beneficiaries compared with the broader population.
Medicare beneficiaries who receive care through CMS’s largest voluntary value-based payment models are disproportionately White and less likely to be dual eligible for Medicare and Medicaid or live in disadvantaged or rural areas than those outside these models, according to a new research letter published in JAMA Health Forum.
Examining Beneficiary Representation in CMS Value-Based Payment Models
CMS has tested more than 50 value-based payment models aimed at improving quality while controlling costs by holding clinicians and health care organizations accountable for spending and quality outcomes.
Because most of these models have been voluntary, clinicians and organizations can choose whether to participate, raising concerns about selection bias and whether findings generalize to the broader Medicare population. To assess whether voluntary participation affected beneficiary representation, researchers compared beneficiaries receiving care through Medicare’s largest voluntary models from 2013 to 2022 with the overall Medicare fee-for-service (FFS) population