9 in 10 Health Plans Still Tied to FFS Model

The Catalyst for Payment Reform (CPR), an independent, non-profit group working on behalf of large healthcare purchasers, Tuesday released its first annual National Scorecard on Payment Reform, which showed that 89.1% of these payments are still based on the traditional fee-for-service model and not tied to improving quality outcomes or reducing waste.

The balance, 10.9% of payments made by commercial health plans to providers, are value-oriented, CPR determined.

Funded by the Commonwealth Fund and the California HealthCare Foundation, the scorecard is based on data voluntarily submitted by health plans on a self-reported basis to eValue8, the National Business Coalition on Health's annual Request for Information to health plans. The data represents nearly half of individuals covered by commercial health plans.

During a live webinar announcing the scorecard results, Suzanne Delbanco, CPR executive director, said the organization has set a goal to have 20% of commercial health plan payments be value-oriented by 2020.

"We help organize all of these purchasers to ask for the same changes at the same time so we can really move the dial. We try to highlight the urgency of payment reform and highlight the urgency of action, and the scorecard is part of what is helping us do that today," Delbanco says.