By Kelly A. Briganti, JD, Editorial Director G2 Intelligence
There has been much discussion about moving away from fee for service reimbursement and the need to tie reimbursement to the value provided, rather than the amount of care provided. That discussion takes on new urgency now that HHS has announced the following specific timing objectives for shifting to value based payment:
- 30 percent of fee-for-service Medicare payments linked to value or quality by 2016’s end and 50 percent by 2018 through use of alternative payment models including Accountable Care Organizations and bundled payment arrangements.
- “[T]ying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs.”
HHS’s press release announcing the timeline declares: “This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.”
In March 2015, a newly created Health Care Payment Learning and Action Network will meet and begin its objective of working with payers, providers, employers, Medicaid programs and others on integrating alternative payment models. HHS also reports that Medicare has already saved $417 million due to Accountable Care Organizations, and that currently “approximately 20 percent of Medicare payments” are made through alternative payment models.
For more information, see HHS’s Jan. 26 press release, with links to related information and resources: http://www.hhs.gov/news/press/2015pres/01/20150126a.html