The Department of Health and Human Services intends to shift Medicare payments from volume to value—tying 30 percent of traditional Medicare payments to alternative payment models and tying 85 percent of all traditional Medicare payments to quality or value—by the end of 2016. But, are providers ready to participate in value-based payment models?
It’s a question the Healthcare Information and Management Systems Society is attempting to answer with its new HIMSS Cost Accounting Survey. In the survey, which can be taken online through Dec. 31, providers are asked to rate their readiness to transition from a fee-based to a value-based payment model and identify what they need from an industry perspective to make this transition successful.
Paying providers based on quality rather than the quantity of care is no trivial pursuit. It marks the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.
“We need to begin thinking about how the industry can support providers in making the transition to value-based payment in a meaningful and widespread way,” said Pamela Jodock, HIMSS senior director, health business solutions. “From a health IT perspective, what infrastructure do we need to have in place for a successful transition? The survey is intended to help us start that conversation.”
The Centers for Medicare and Medicaid Services last week released its 2016 CMS Quality Strategy in support of Medicare’s shift from volume to value, which the agency states will require “better organization and use of data and health information, including the use of electronic health records and other health IT resources” as well as paying providers to incentivize quality instead of quantity. “Smarter payments will help cut down on inefficiencies and the overuse of costly tests and other diagnostics,” states the document. To achieve those goals, CMS said it will measure and publicly report providers’ quality performance and cost of services provided.
In this regard, the HIMSS survey asks providers to answer questions about the importance their organizations place on price transparency and whether or not they currently publish or plan to publish their prices. The survey also asks providers what kinds of processes, automated abilities or cost accounting systems they use to determine costs, as well as what factors they use to determine price and the relative importance they place on these factors.
According to Jodock, in a value-based payment environment providers must understand the true costs of delivering care and how to price services to be financially viable, which will most likely require cost assessment and revenue cycle management tools allowing them to accurately capture or predict a wide range of factors influencing their clinical and operational costs.
Providers can take the HIMSS Cost Accounting Survey here. Survey results will be released and presented at the 2016 HIMSS Conference being held Feb. 29-March 4, 2016 in Las Vegas.
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