Medicare Unveils Alternative Payment Models

Christopher Cheney, January 27, 2015

HHS officials highlight a three-year payment reform timeline, which calls for boosting fee-for-service Medicare reimbursements and increasing reimbursements linked to quality and value.

Federal officials have announced an accelerated effort to use payment reform as a mechanism to shift Medicare and the broader healthcare industry away from the fee-for-service model.

During a gathering in the nation's capital Monday, nearly two dozen healthcare industry stakeholders, including providers, commercial payers, and Department of Health and Human Services Secretary Sylvia Burwell, announced plans to ramp up Medicare payment reforms featuring alternative payment models and value-based payments.


Sylvia Mathews Burwell
HHS Secretary

Photo: Varnent

"Whether you are a patient, a provider, a business, a health plan, or a taxpayer, it is in our common interest to build a healthcare system that delivers better care, spends healthcare dollars more wisely and results in healthier people," Burwell said. "We believe these goals can drive transformative change, help us manage and track progress, and create accountability for measurable improvement."

SGR: Medicare Reforms Proposed as Funding Offset

In a statement released Monday morning, HHS officials said the payment reform initiative includes creation of a "learning and action network" to promote the development and promulgation of value-based payment models. "HHS will intensify its work with states and private payers to support adoption of alternative payments models through their own aligned work, sometimes even exceeding the goals set for Medicare. The Network will hold its first meeting in March."

3-Year Timeline
In a conference call Monday afternoon with members of the media, senior HHS officials highlighted a three-year payment reform timeline, which calls for boosting the percentage of fee-for-service Medicare reimbursements based on alternative payment models (APM) and increasing the percentage of all reimbursements linked to quality and value.

Christopher Cheney

Christopher Cheney is the senior finance editor at HealthLeaders Media.


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