Medicare is comprised of three primary models: Fee For Service Medicare, Accountable Care Organizations, and Medicare Advantage plans. Each model has a distinct quality measurement system, with disparate measures that do not cross programs, making cross-program performance assessment challenging. This paper reviews each of the quality measurement systems along with their strengths and weaknesses. Next, the paper reviews correlation of quality measurement across programs, finding that measure correlation across programs is poor. Finally, the paper suggests potential steps for regulators and policymakers to take in order to create a unified quality measurement and bonus/penalty system across Medicare, along with concurrent options for improving Medicare financing.

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