HHS Outlines Value-Based Payment Goals
Thursday, February 12, 2015 06:49 PM

By 2016, the Department of Health and Human Services (HHS) is aiming to have 85% of provider payments under Medicare's fee-for-service system based on the quality or value of care rather than volume, the agency announced.  The announcement came in a meeting with "with nearly two dozen leaders representing consumers, insurers, providers, and business leaders." HHS is hoping to have 90% of the payments based on value or quality by 2018, the release said, noting that the payments would be made through programs such as the Hospital Value Based Purchasing Program and the Hospital Readmissions Reduction Program.

In addition, by the end of 2016, the agency hopes to be making 30% of its payments through alternative payment models like accountable care organizations (ACOs) -- affiliations of doctors, hospitals, and other providers that jointly care for Medicare patients -- upping that percentage to 50% by the end of 2018. This is the first time the agency has announced specific goals for these types of payments, which currently represent 20% of Medicare's $362 billion in fee-for-service payments.

HHS has already shown savings of $417 million to Medicare from existing ACO programs, the release noted. On the question of whether switching to these payment mechanisms will mean lower reimbursement for physicians, it was noted that "real wages for physicians have been decreasing for years. This is more about how they will be paid in the future."

"Over time, physicians will need to perform on quality metrics -- just as hospitals and health plans do -- to see favorable compensation."


Source:  http://www.medpagetoday.com/PracticeManagement/Reimbursement/49727