Data-Driven Incentive Design in the Medicare Shared Savings Program
Published Online:28 May 2019https://doi.org/10.1287/opre.2018.1821
References
- (2016) Bundled payment vs. fee-for-service: Impact of payment scheme on performance. Management Sci. 63(5):1606–1624.Link, Google Scholar
- (2001) Inverse optimization. Oper. Res. 49(5):771–783.Link, Google Scholar
- Akira Health, Inc. (2017) Akira health accountable care organization. Accessed June 1, 2018, http://www.akirahealth.com/.Google Scholar
- (1984) Hospital readmissions in the Medicare population. New England J. Medicine 311(21):1349–1353.Crossref, Google Scholar
- (2015) Incentive programs for reducing readmissions when patient care is co-produced. Production Oper. Management 27(6):999–1020.Google Scholar
- (2012) Consumption externality and yield uncertainty in the influenza vaccine supply chain: Interventions in demand and supply sides. Management Sci. 58(6):1072–1091.Link, Google Scholar
- (2018) Inverse optimization with noisy data. Oper. Res. 66(3):870–892.Link, Google Scholar
- (2013) On hospice operations under medicare reimbursement policies. Management Sci. 59(5):1027–1044.Link, Google Scholar
- (2012) Optimizing organic waste to energy operations. Manufacturing Service Oper. Management 14(2):231–244.Link, Google Scholar
- (2004) When not all conflict is bad: Manufacturing-marketing conflict and strategic incentive design. Management Sci. 50(4):489–502.Link, Google Scholar
- (2016) Analysis of medicare pay-for-performance contracts. Working paper, University of Pennsylvania, Philadelphia.Google Scholar
- (2015) Data-Driven Estimation in Equilibrium Using Inverse Optimization. Mathematical Programming Series A, vol. 153 (Springer-Verlag, Berlin, Heidelberg), 595–633.Google Scholar
- (2011) Launching accountable care organizations: The proposed rule for the medicare shared savings program. New England J. Medicine 364(16):e32.Crossref, Google Scholar
- (2012) Eliminating waste in US health care. J. Amer. Medical Assoc. 307(14):1513–1516.Crossref, Google Scholar
- (2015) Mathematical Statistics: Basic Ideas and Selected Topics, vol. 2 (CRC Press, Boca Raton, FL).Google Scholar
- (2015) An Introduction to the Theory of Mechanism Design (Oxford University Press, New York).Crossref, Google Scholar
- (2019) Consumer subsidies with a strategic supplier: Commitment vs. flexibility. Management Sci. 65(2):681–713.Google Scholar
- (2000) Sales-force incentives and inventory management. Manufacturing Service Oper. Management 2(2):186–202.Link, Google Scholar
- (2016) Incentive alignment and coordination of project supply chains. Management Sci. 63(4):1011–1025.Link, Google Scholar
- (2015) Incentive contracts in serial stochastic projects. Manufacturing Service Oper. Management 17(3) 290–301.Link, Google Scholar
- (2014) Refining the ACO Program: Issues and Options (Department of Healthcare Policy, Harvard Medical School, Boston).Google Scholar
- (2008) Supply chain coordination and influenza vaccination. Oper. Res. 56(6):1493–1506.Link, Google Scholar
- CMS (2016a) 2016 Press release: Physicians and health care providers continue to improve quality of care, lower costs. Accessed September 1, 2016, https://www.cms.gov/newsroom/press-releases/physicians-and-health-care-providers-continue-improve-quality-care-lower-costs. Google Scholar
- CMS (2016b) About the program: Centers for Medicare and Medicaid Services. Accessed June 1, 2016, https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/about.html.Google Scholar
- CMS (2016c) ACO investment model: Centers for Medicare and Medicaid Services. Accessed June 1, 2016, https://innovation.cms.gov/initiatives/ACO-_Investment-_Model/.Google Scholar
- CMS (2016d) Program guidelines and specifications: Improving quality of care for medicare patients: Accountable care organizations. Accessed August 1, 2018, https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/program-guidance-and-specifications.html. Google Scholar
- CMS (2017a) Medicare shared savings program accountable care organizations performance year 2015 results. Accessed August 1, 2018, https://data.cms.gov/Special-Programs-Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/x8va-z7cu.Google Scholar
- CMS (2017b) Bundled payments for care improvement (BPCI) initiative: General information. Accessed August 1, 2018, https://innovation.cms.gov/initiatives/bundled-_payments/.Google Scholar
- (2015a) The impact of demand uncertainty on consumer subsidies for green technology adoption. Management Sci. 62(5):1235–1258.Link, Google Scholar
- (2015b) Competition and externalities in green technology adoption. Working paper, New York University, New York.Google Scholar
- (2011) The accountable care organization: Whatever its growing pains, the concept is too vitally important to fail. Health Affairs 30(7):1250–1255.Crossref, Google Scholar
- (2007) Store manager incentive design and retail performance: An exploratory investigation. Manufacturing Service Oper. Management 9(4):518–534.Link, Google Scholar
- (2002) Foundations of Bilevel Programming (Springer Science & Business Media, New York).Google Scholar
- (2015) Avoiding unintended incentives in ACO payment models. Health Affairs (Millwood) 34(1):143–149.Crossref, Google Scholar
- (2012) A simulation shows limited savings from meeting quality targets under the Medicare shared savings program. Health Affairs (Millwood) 31(11):2554–2562.Crossref, Google Scholar
- (1994) An Introduction to the Bootstrap (CRC Press, Boca Raton, FL).Crossref, Google Scholar
- Federal Register (2011) Medicare shared savings program: Accountable care organizations. Final rule. Federal Register 76(212):67802.Google Scholar
- (2012) A framework for evaluating the formation, implementation, and performance of accountable care organizations. Health Affairs (Millwood) 31(11):2368–2378.Crossref, Google Scholar
- (2001) Outcomes-adjusted reimbursement in a health-care delivery system. Management Sci. 47(6):735–751.Link, Google Scholar
- (2008) Is American health care uniquely inefficient? Technical report, National Bureau of Economic Research, Cambridge, MA.Crossref, Google Scholar
- (1998) Incentives in organizations. Technical report, National Bureau of Economic Research, Cambridge, MA.Crossref, Google Scholar
- (1989) Adverse risk incentives and the design of performance-based contracts. Management Sci. 35(7):807–822.Link, Google Scholar
- (1983) An analysis of the principal-agent problem. Econometrica 51(1):7–45.Crossref, Google Scholar
- (2012) Impact of performance-based contracting on product reliability: An empirical analysis. Management Sci. 58(5):961–979.Link, Google Scholar
- (2016) The impact of reimbursement policy on patient welfare, readmission rate and waiting time in a public healthcare system: Fee-for-service vs bundled payment. Working paper, London Business School, London.Google Scholar
- (2015) Bundled payments for healthcare services: Proposer selection and information sharing. Oper. Res. 63(4):772–788.Link, Google Scholar
- (1979) Optimal incentive contracts with imperfect information. J. Econom. Theory 20(2):231–259.Crossref, Google Scholar
- (1986) The Theory of Contracts (Department of Economics, Massachusetts Institute of Technology, Cambridge, MA).Google Scholar
- (2005) The elements of statistical learning: Data mining, inference and prediction. Math. Intelligencer 27(2):83–85.Crossref, Google Scholar
- (2011) The ACO model—A three-year financial loss? New England J. Medicine 364(14):e27.Crossref, Google Scholar
- (2010) Addressing overutilization in medical imaging. Radiology 257(1):240–245.Crossref, Google Scholar
- (1979) Moral hazard and observability. Bell J. Econom. 10(1):74–91.Crossref, Google Scholar
- (2016) Capacity management for outpatient medical services under competition and performance-based incentives. Working paper, Wharton School, University of Pennsylvania, Philadelphia.Google Scholar
- (2012) Performance-based contracts for outpatient medical services. Manufacturing Service Oper. Management 14(4):654–669.Link, Google Scholar
- (2013) The impact of the manufacturer-hired sales agent on a supply chain with information asymmetry. Manufacturing Service Oper. Management 16(1):76–88.Link, Google Scholar
- (2010) The effect of delayed incentives on supply chain profits and consumer surplus. Production Oper. Management 19(2):172–197.Crossref, Google Scholar
- (2009) The Theory of Incentives: The Principal-Agent Model (Princeton University Press, Princeton, NJ).Crossref, Google Scholar
- (2015) OM forum—Supply chain contracting: doughnuts to bubbles. Manufacturing Service Oper. Management 18(3):309–313.Link, Google Scholar
- (2012) An evidence-based incentive system for Medicare’s end-stage renal disease program. Management Sci. 58(6):1092–1105.Link, Google Scholar
- (2016) On the effectiveness of uniform subsidies in increasing market consumption. Management Sci. 63(1):40–57.Link, Google Scholar
- (2011) Building regulatory and operational flexibility into accountable care organizations and ‘shared savings.’ Health Affairs (Millwood) 30(1):23–31.Crossref, Google Scholar
- (2014) An agent-based simulation model to study accountable care organizations. Health Care Management Sci. 19(1):89–101.Crossref, Google Scholar
- (2013) A game-theoretic model of international influenza vaccination coordination. Management Sci. 59(7):1650–1670.Link, Google Scholar
- (1951) The Kolmogorov-smirnov test for goodness of fit. J. Amer. Statist. Assoc. 46(253):68–78.Crossref, Google Scholar
- (2003) The quality of health care delivered to adults in the United States. New England J. Medicine 348(26):2635–2645.Crossref, Google Scholar
- (2015) Performance differences in year 1 of pioneer accountable care organizations. New England J. Medicine 372(20):1927–1936.Crossref, Google Scholar
- (2016) Early performance of accountable care organizations in medicare. New England J. Medicine 374(24):2357–2366.Crossref, Google Scholar
- (2013) Changes in health care spending and quality for Medicare beneficiaries associated with a commercial ACO contract. J. Amer. Medical Assoc. 310(8):829–836.Crossref, Google Scholar
- (2010) Healthcare spending and the medicare program. Medicare Payment Advisory Commission. Accessed August 1, 2018, http://67.59.137.244/documents/Jun10DataBookEntireReport.pdf.Google Scholar
- (2006) Pay-for-performance: The MedPAC perspective. Health Affairs (Millwood) 25(2):413–419.Crossref, Google Scholar
- (2009) From volume to value: Better ways to pay for health care. Health Affairs (Millwood) 28(5):1418–1428.Crossref, Google Scholar
- (2011) The Work Ahead: Activities and Costs to Develop an Accountable Care Organization (American Hospital Association, Chicago).Google Scholar
- (1981) Optimal auction design. Math. Oper. Res. 6(1):58–73.Link, Google Scholar
- National Association of ACOs (2014) National ACO survey. Accessed June 1, 2016, https://www.naacos.com/assets/docs/pdf/acosurveyfinal012114.pdf.Google Scholar
- OECD (2016) Organization for economic cooperation and development health statistics. Accessed September 1, 2018, http://www.oecd.org/els/health-systems/health-data.htm.Google Scholar
- (2000) Performance-based incentives in a dynamic principal-agent model. Manufacturing Service Oper. Management 2(3):240–263.Link, Google Scholar
- (2003) Relative performance of incentive mechanisms: Computational modeling and simulation of delegated investment decisions. Management Sci. 49(2):160–178.Link, Google Scholar
- (2011) The ACO rules—Striking the balance between participation and transformative potential. New England J. Medicine 365(4):e6.Crossref, Google Scholar
- (2004) Paying for quality: Providers’ incentives for quality improvement. Health Affairs (Millwood) 23(2):127–141.Crossref, Google Scholar
- (2016) Yardstick competition for service systems. Working paper, London Business School, London.Google Scholar
- (1979a) On moral hazard and insurance. Dionne G, Harrington SE, eds. Foundations of Insurance Economics (Springer, New York), 280–301.Crossref, Google Scholar
- (1979b) Risk sharing and incentives in the principal and agent relationship. Bell J. Econom. 10(1):55–73.Crossref, Google Scholar
- (2000) Modeling the impact of an outcome-oriented reimbursement policy on clinic, patients, and pharmaceutical firms. Management Sci. 46(7):875–892.Link, Google Scholar
- (2000) Is US health really the best in the world? J. Amer. Medical Assoc. 284(4):483–485.Crossref, Google Scholar
- (2014) Subsidizing the distribution channel: Donor funding to improve the availability of malaria drugs. Management Sci. 60(10):2461–2477.Link, Google Scholar
- (2002) Geography and the debate over Medicare reform. Health Affairs (Millwood) 21(2):10.Google Scholar
- (1992) Contracting for software development. Management Sci. 38(3):307–324.Link, Google Scholar
- (2013) Developing a viable alternative to Medicare’s physician payment strategy. Health Affairs (Millwood) 33(1):153–160.Crossref, Google Scholar
- (2013) Incentives’ effect in influenza vaccination policy. Management Sci. 59(12):2667–2686.Link, Google Scholar
- (2016a) Hospital readmissions reduction program: An economic and operational analysis. Management Sci. 62(11):3351–3371.Link, Google Scholar
- (2016b) Modeling and designing health care payment innovations for medical imaging. Health Care Management Sci. 21(1):37–51.Crossref, Google Scholar

