Better, Smarter, Healthier: In historic announcement, HHS sets clear goals and timeline for shifting Medicare reimbursements from volume to value
Contact: HHS Press Office, 202-690-6343
Better, Smarter, Healthier: In historic announcement, HHS sets clear goals and timeline for shifting
In a meeting with nearly two dozen leaders representing consumers, insurers, providers, and business leaders, Health and Human Services Secretary
HHS has set a goal of tying 30 percent of traditional, or fee-for-service,
To make these goals scalable beyond
"Whether you are a patient, a provider, a business, a health plan, or a taxpayer, it is in our common interest to build a health care system that delivers better care, spends health care dollars more wisely and results in healthier people. Today's announcement is about improving the quality of care we receive when we are sick, while at the same time spending our health care dollars more wisely,"
"We're all partners in this effort focused on a shared goal. Ultimately, this is about improving the health of each person by making the best use of our resources for patient good. We're on board, and we're committed to changing how we pay for and deliver care to achieve better health,"
"Advancing a patient-centered health system requires a fundamental transformation in how we pay for and deliver care. Today's announcement by
"Employers are increasingly taking steps to support the transition from payment based on volume to models of delivery and payment that promote value," said
"Today's announcement will be remembered as a pivotal and transformative moment in making our health care system more patient- and family-centered," said
The Affordable Care Act created a number of new payment models that move the needle even further toward rewarding quality. These models include ACOs, primary care medical homes, and new models of bundling payments for episodes of care. In these alternative payment models, health care providers are accountable for the quality and cost of the care they deliver to patients. Providers have a financial incentive to coordinate care for their patients - who are therefore less likely to have duplicative or unnecessary x-rays, screenings and tests. An ACO, for example, is a group of doctors, hospitals and health care providers that work together to provide higher-quality coordinated care to their patients, while helping to slow health care cost growth. In addition, through the widespread use of health information technology, the health care data needed to track these efforts is now available.
Many health care providers today receive a payment for each individual service, such as a physician visit, surgery, or blood test, and it does not matter whether these services help - or harm - the patient. In other words, providers are paid based on the volume of care, rather than the value of care provided to patients. Today's announcement would continue the shift toward paying providers for what works - whether it is something as complex as preventing or treating disease, or something as straightforward as making sure a patient has time to ask questions.
In 2011,
HHS has already seen promising results on cost savings with alternative payment models, with combined total program savings of
To read a new Perspectives piece in the
To read more about why this matters: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-2.html
To read a fact sheet about the goals and Learning and Action Network: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-3.html
To learn more about Better Care, Smarter Spending, and Healthier People: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26.html
Participants in today's meeting include:
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