CMMI asks for ideas on post-acute care payment model at AHA annual meeting
The head of the Center for Medicare and Medicaid Innovation told the crowd at the American Hospital Association's annual meeting Monday his agency is considering a new payment model for post-acute care and is calling for ideas from hospital leaders.
Adam Boehler, who also advises HHS Secretary Alex Azar on value-based care, said this is a "great time" to give the agency thoughts on where there could be opportunities to lower costs while improving quality.
He also discussed developing payment models in rural areas to allow those facilities to adapt to changing dynamics in the industry. Boehler pointed to Pennsylvania as an example of a "great experiment" in global payments, in which hospitals receive a fixed monthly payment to deliver inpatient and outpatient care.
HHS officials have continued to push for new payment models in an effort to move the industry away from getting reimbursed for the quantity of services in favor of reimbursing for quality of care.
Last month, the administration announced it was revamping the way it pays for kidney care in the United States, potentially affecting the treatment of 37 million Americans with kidney disease. HHS wants to try a payment model that encourages better care in the early stages of the disease, improve access to transplants and focus on treatment at home instead of inconvenient treatment that can last for hours at outpatient centers.
Boehler is well known for his thoughts on the need to address perverse incentives in current reimbursement models, recently announcing a plan to alter incentives for ground ambulances. Currently, ambulances get reimbursed for each transport, but the new plan aims to lower costs by avoiding unnecessary rides.
But despite the push for shifting payment models, providers are still hesitant to take on downside risk. A recent report from the Government Accountability Office found that providers often drop out of voluntary payment model reform when they're forced to assume more risk.