There are still roadblocks for effective use of data in value-based care models, experts say.
Real-world evidence can be a driving force behind value-based payments, but the healthcare system has a ways to go before that is a reality, experts said.
As the buzz around a single-payer health system based around Medicare grows, a former Department of Health and Human Services secretary says it's crucial to keep eyes on a more pressing problem: Medicare is running out of money.
WASHINGTON – The Patient-Centered Primary Care Collaborative (PCPCC) this week called on the Centers for Medicare and Medicaid Services (CMS) to maintain progress on its efforts to drive the shift to value, while empowering beneficiaries through the support of reliable access to primary care.
Perhaps the biggest value-based challenge on the finance side is the lack of a single set of metrics by which to gauge quality.
The Department of Health and Human Services threw down the gauntlet in late January when Secretary Sylvia Burwell announced its intention to increase value-based purchasing dramatically in the next few years.
HHS plans to move its payment system to 30 percent value-based in 2016 and 50 percent by 2018. It also plans to have 95 percent of fee-for-service plans include some sort of value and efficiency components by 2018.
The Patient-Centered Primary Care Collaborative (PCPCC) applauds the U.S. Department of Health and Human Services’ (HHS) goal for 30 percent of Medicare payments to be in alternative payment models by the end of 2016 and 50 percent by the end of 2018.
HHS’s commitment to alternative payment models, like Accountable Care Organizations (ACOs) and bundled payments, as well as innovative care delivery models, like the Patient-Centered Medical Home (PCMH), signifies a positive shift in payment reform policy that moves away from the traditional fee-for-service (FFS) system.
A large payer and health system in California are embroiled in a bitter feud over expired contract terms, the type of fight all too common in the fee-for-service world. With healthcare switching to value-based care, some had hoped these types of financial squabbles would disappear as the interests of providers and payers became more closely aligned on reducing costs.
As we approach the one-year anniversary of Obamacare’s launch, the pundits continue to argue over whether or not it’s working. Meanwhile, something much bigger is happening. Whatever you think of its merits, the Affordable Care Act is re-shaping American healthcare, radically altering business models that hadn’t changed in decades.
