Author Interviews, Cost of Health Care, Medicare, UCLA / 08.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50628" align="alignleft" width="154"]Auyon Siddiq PhD Assistant Professor/INFORMS Member Decisions, Operations & Technology Management  UCLA Anderson School of Management Dr. Siddiq[/caption] Auyon Siddiq PhD Assistant Professor/INFORMS Member Decisions, Operations & Technology Management UCLA Anderson School of Management MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Medicare Shared Savings Program (MSSP) was created under the Patient Protection and Affordable Care Act to control escalating Medicare spending by incentivizing providers to deliver healthcare more efficiently. Medicare providers that enroll in the MSSP earn bonus payments for reducing spending to below a risk-adjusted financial benchmark that depends on the provider's historical spending. To generate savings, a provider must invest to improve efficiency, which is a cost that is absorbed entirely by the provider under the current contract. This has proven to be challenging for the MSSP, with a majority of participating providers unable to generate savings due to the associated costs. This study presents a predictive analytics approach to redesigning the MSSP contract, with the goal of better aligning incentives and improving financial outcomes from the MSSP. We build our model from data containing the financial performance of providers enrolled in the MSSP, which together accounted for 7 million beneficiaries and over $70 billion in Medicare spending.