A new Health Care Payment Learning & Action Network (LAN) report found that 29% of U.S. healthcare payments were connected to alternative payment models (APMs) in 2016. That was an increase from 23% the previous year.
LAN, a public-private partnership that HHS created in 2015 to promote APMs, said the results were close to its goal of having 30% of healthcare payments tied to APMs by 2016. The group hopes that number will increase to 50% by next year.
At LAN’s Fall Summit on Monday, CMS Administrator Seema Verma said the CMS is revising current quality measures across all quality payment programs and wants to cut regulatory burdens for providers.
LAN’s report tracks healthcare spending from four sources: the LAN, America’s Health Insurance Plans, the Blue Cross Blue Shield Association and the CMS. LAN said the report accounts for nearly 245.4 million people, which is about 84% of the covered population.
Researchers found that:
43% of healthcare payments went to traditional fee-for-service (FFS) or other legacy payments that weren't linked to quality;
29% went to shared savings, shared risk, bundled payments or population-based payments; and
28% went to pay-for-performance or care coordination fees.
The researchers found health insurance companies are moving away from traditional FFS to value-based reimbursements because of improved quality and cost outcomes.
The LAN announced the findings at its fall summit. Verma also spoke at the event and said one of her top priorities is to “ease regulatory burden that is destroying the doctor-patient relationship.” Misguided, outdated and complex rules are forcing patients to spend less time with patients and more time filing unnecessary paperwork, which also increases the costs of care, she said.
Measuring quality is a critical component of paying for value, but reporting those measures are burdensome for providers. With that in mind, Verma said the CMS is revising current quality measures across all of its programs, including the Hospital Star Ratings and MACRA programs.
Verma also announced the Meaningful Measures initiative that will take quality measuring advice from the LAN, National Academies of Medicine, Core Quality Measures Collaborative and National Quality Forum. The program will focus on “high-priority areas” rather than having CMS “micromanage and measure processes,” said Verma.
In addition, Verma said the CMS is moving the Center for Medicare and Medicaid Innovation in a new direction that will “promote greater flexibility and patient education.”
“Our vision is to develop models that promote a patient-centered system of care within a market-driven healthcare system. Models should empower consumers to make decisions that are right for them and providers should compete around value and quality,” she said.
Verma added that the CMS is especially interested in starting demonstrations in primary care, consumer-driven healthcare, Medicare Advantage, reducing prescription drug costs, behavioral health, opioid addiction and state-based and local innovation models to manage costs for dual-eligibles.