Medicare sets specific benchmarks for value-based reimbursement
- The Obama administration on Monday announced goals for overhauling the Medicare payment system to reward quality over volume. For the first time, HHS tied specific benchmarks to the overhaul, announcing that it is aiming for for 30% of payments for traditional Medicare benefits to be tied to alternative payment models by the end of 2016; and 50% by the end of 2018.
- HHS indicated that it wants greater portions of payments to be tied to quality or value, and would like 85% of Medicare's hospital payments made through programs such as the Hospital Value-Based Purchasing Program or the Hospital Readmissions Reduction Program by the end of 2016. That number jumps to 90% by the end of 2018.
- Most healthcare organizations, including the American Hospital Association, said they support the plan, but the American Medical Association said it needs more specifics before giving its blessing.
Although this is the first time specific benchmarks have been set, the plan is still a little fuzzy around the edges. How HHS will implement the plan has yet to be revealed, making at least the AMA cautious. Still, the benchmarks it has set aren't out of the realm of possibility. According to HHS, 20% of Medicare payments for traditional beneficiaries are already made through alternative payments models, so the goal of increasing that number is reasonable.
In the same announcement, HHS revealed the Health Care Payment Learning and Action Network, which aims to help foster the growth of value-based payment models to different insurance sectors, including employer-based coverage and state Medicaid programs. The first meeting will be held in March.
- ABC News Gov't to Overhaul Medicare Payments to Doctors, Hospitals
- Modern Healthcare (Subscription Required) HHS sets goals for expanding new Medicare payment models