New Program Accelerates Move to Value-Based Care Payments

The White House and healthcare industry stakeholders on March 25 officially launched a new nationwide program to rapidly move away from fee-for-service payments and adopt value-based reimbursement methods.

President Obama in January announced formation of the Healthcare Payment Learning and Action Network, and registration started in February. Since then, about 2,800 payers, providers, states, consumer groups and other organizations have joined.

Also See: Medicare to Significantly Accelerate Value-based Payments

The Department of Health and Human Services announced in January the goal of tying 30 percent of FFS Medicare payments to quality or value through alternative payment models (ACOs, bundled payments, etc.) by 2016 and hitting 50 percent by the end of 2018. HHS also wants to tie 85 percent of traditional Medicare payments to value by 2016 and 90 percent by 2018 through the Hospital Value Based Purchasing and Hospital Readmission Reduction Programs.

Consequently, the goal of the Healthcare Payment Learning and Action Network is to work with private stakeholders to create their own alternative payment models. Such models today account for about 20 percent of Medicare payments.

CMS is funding the Network through monies allocated in the Affordable Care Act. “CMS will fund an independent contractor who will be responsible for convening the Network,” according to an agency statement. “A guiding committee will be created to identify priorities and provide recommendations to the Network convener. The guiding committee will be composed of participants from the Network. Workgroups will be created by the convener in consultation with the guiding committee to address specific topics. Participants in workgroups will be drawn from Network participants. Information will be shared with the entire Network through written communications, regulatory scheduled webinars and in-person meetings.

Among early stakeholder commitments, Cigna has agreed to match the HHS goals with a focus on incenting and assisting physicians, the American College of Physicians will provide education on the initiative to its members and Caesars Entertainment has started a bundled payment demonstration project that includes reduced cost sharing for employees.

Health information technology vendors were well represented at the kick-off of the initiative at the White House today, says Jennifer Covich Bordenick, CEO at eHealth Initiative, an industry stakeholder consortium. That’s important, she adds, because the Healthcare Payment Learning and Action Network brings new emphasis on the value that technology and data play in keeping costs down and improving quality.

Technology to support exchanging and analyzing data, coordinating care and engaging consumers will be critical components for success, Bordenick believes. “Everyone will be focused on figuring out how to move the data so you can use it for alternative payment models.” The new initiative also is a major opportunity for the HIT industry to demonstrate its value, “and that’s a good thing,” she adds.

More information on the Healthcare Payment Learning and Action Network, including a fact sheet, frequently asked questions, a list of participants that have committed to specific goals and a registration page, is available here.

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