We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Viewpoint |

Specialty-Based Global Payment A New Phase in Payment Reform

Zirui Song, MD, PhD1,2; Carrie H. Colla, PhD3,4
[+] Author Affiliations
1Department of Medicine, Massachusetts General Hospital, Boston
2Harvard Medical School, Boston, Massachusetts
3Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
4Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
JAMA. 2016;315(21):2271-2272. doi:10.1001/jama.2016.4318.
Text Size: A A A
Published online


This Viewpoint discusses Medicare’s new Oncology Care Model and how it may serve as a model for specialty-based global payment.

To control health care spending and improve quality, public and private payers are increasingly moving away from fee-for-service toward global payment contracts with pay-for-performance. To date, global payment has been centered on the role of primary care physicians coordinating all care, including specialty care. In 2016, Medicare plans to begin a new contracting model for cancer care that may serve as a model for specialty-based global payment.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Payment Models in the Traditional Medicare Program

aAs of January 1, 2016, participants included 337 awardees and 1237 episode initiators (including 409 acute care hospitals, 700 skilled nursing facilities, 288 physician group practices, 100 home health agencies, 9 inpatient rehabilitation facilities, and 1 long-term care hospital) according to the CMS.

bThe Merit-Based Incentive Payment System (MIPS) will adjust physician fees up or down based on quality, electronic health record adoption, and other factors as part of the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015 (MACRA).

Graphic Jump Location



Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

Care at the Close of Life: Evidence and Experience
Reimbursement and Economic Issues: Why Oncology Is Different