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Task Force Calls on CMS to Encourage Alternative Payment Models

News  |  By Gregory A. Freeman  
   November 27, 2017

Some strategies are showing promise but require time for real change to occur. Recent CMS moves may be slowing the momentum.

The Center for Medicare and Medicaid Services (CMS) should continue refining existing alternative payment models that are showing genuine long-term promise, says an industry consortium of patients, payers, providers and purchasers.

The Health Care Transformation Task Force (HCTTF) says finding alternatives to the prevailing fee-for-service payment system should be a top priority as CMS reorients the Center for Medicare & Medicaid Innovation’s (CMMI) agenda.

The task force comments came in a letter responding to a CMS request for information about new directions for CMMI, the agency’s test lab for value-based payment models. HCTTF pushed for more innovation, noting that there are attractive private sector models that warrant consideration for testing in Medicare and Medicaid, while also cautioning that the agency should not abandon promising current models.

The healthcare industry has made progress that should be encouraged, says Jeff Micklos, HCTTF’s executive director.

“Transformation of this magnitude takes time, and the results from the current models are paying off,” he says. “The most determinative factor of success in value-based arrangements is the length of time in which a provider participates. More time allows for greater improvements in care delivery.”

CMS recently released the 2016 results of four Medicare Accountable Care Organization (ACO) programs, which reduced gross Medicare spending by $836 million that year, returning $70.6 million in net savings to the Medicare Trust Fund. HCTTF also urged CMS to recognize the major investments stakeholders have made in models such as the accountable care and bundled payment programs as it weighs its program mix going forward.

The task force also asked CMS to refine models to make a better business case for delivery system innovation, noting that providers who have already implemented measures to control cost and improve quality should receive credit when setting future benchmarks.

Gregory A. Freeman is a contributing writer for HealthLeaders.

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