Medicare continues to develop quality assessment programs and value‐based purchasing initiatives. While the overall goal appears as attaining quality of care, there is also an aspect of trying to reduce costs. Thus there is a fundamental conflict between provision of care and payment for such care relative to the type and level of care being justified based upon quality measures. There is also a fundamental difference between quality and perceived quality of care. In other words, from whose perspective are we determining quality of care?
In this workshop, we address the many efforts that the Medicare program is currently undertaking and/or is in the process of developing. The latest major efforts involve mandates from MACRA (Medicare Access & CHIP Reauthorization Act) relative to the discontinuation of the SGR (Sustainable Growth Rate) through implementation of programs such as MIPS (Merit‐Based Incentive Payment System). Some of the initiatives from Medicare involve cost savings through efficiency improvement, while others involve effectiveness improvement through better care.