Mulligans, handicaps and Medicare.

Not sure what you’re seeing when looking towards the future of the RO-APM? Let’s turn to the past. Since 2012, CMS has been reforming its payment structure for hospitals, and that often includes penalizing for readmissions straight up House of God style. Soon came the outcries that this model doesn’t account for varying patient populations, putting the hurt on safety-net hospitals taking care of some serious gomers. Congress took a mulligan and passed the 21st Century Cures Act requiring Medicare to give handicaps based on “social risk.” In the short term that meant a simple tally of patient income, but the statute allows for different ways to measure social risk to be implemented in the future. This retrospective look at Medicare claims data indicates a more nuanced, if still common sense, approach should also include disability, housing instability, and living on the wrong side of the tracks. Adding these social factors to risk adjustment majorly evened-out the playing field, resulting in over half of analyzed safety-net hospitals looking at reduced (albeit not absent) penalties. TBL: An equitable model for bundled payments ain’t simple. | Joynt-Maddox, Health Serv Res 2019


  1. I am cool with the page and fine with it being an open page. I only bring it up because there was recently a thread on the page discussing the open nature of the page. During that thread it was pointed out that the church opted not to operate a facebook page and so several congregants began and administer the page. There seemed to be a lot of folks who were surprised or had forgotten that the page was unofficial.
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