Based on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medicare payment incentives for physicians to improve the value of health care are ascending toward maximum adjustments in 2022. With this shift, greater attention will be paid to mitigating the danger and cost of health crises for high-need, high-cost older adults.

Several consistent themes emerge from relevant literature. The high-need, high-cost population is not homogeneous, obviating application of a single strategic approach to achieve value. Although not commonly measured, functional status, which is not fully discerned by diagnostic codes in Medicare billing data, has an enormous effect on costs. Finally, the highest-spending population segment has substantial annual turnover, although less so among high-need, high-cost seniors.

中文翻译：

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收费服务数据库和临床医生心态分析之外的可能性

根据2015年《医疗保险访问和CHIP重新授权法案》（MACRA），针对医生提高医疗保健价值的医疗保险激励措施正在朝着2022年的最大调整方向发展。随着这一转变，将更加重视减轻危险和成本高需求，高成本的老年人的健康危机。

相关文献中出现了几个一致的主题。需求高，成本高的人群不是同质的，从而避免了采用单一战略方法来实现价值。尽管不是通常测量的功能状态，但Medicare账单数据中的诊断代码无法完全识别功能状态，却对成本产生了巨大影响。最后，支出最高的人群每年的营业额都很高，尽管在高需求，高成本的老年人中却很少。