** An engineer’s take on ACCESS **
Whenever I hear about a new idea, I think about the poor soul who has to write the code to make this work at scale.
The new Centers for Medicare & Medicaid Services payment model (ACCESS) reimburses organizations for measurable improvements in chronic care outcomes, rather than for individual services. I love the spirit of this concept but how providers actually get paid will be a tough technical challenge.
- What if there are multiple providers for the same patient (I’m doing my Hinge Health exercises and I’m also going to a local PT)
- What is the source of truth to confirm the outcome? (I reported a pain reduction to 3 to Hinge Health and to 4 to my PT)
- How are audits performed? (Can proof of outcome be an in-app pain scale survey?)
The Outcomes-Aligned Payment is highlighted in red to show that attribution is going to be a tricky problem. The most straightforward solution I can think of is an even distribution on preset dates.
Originally posted on LinkedIn.