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Healthcare Organizations Call for Value-based Care Policy

An alliance of 121 healthcare organizations are urging the Trump administration to promote value-based care and healthcare innovation.

Policy Briefing.

Source: Thinkstock.

By Kate Monica

- Leading healthcare organizations from the public and private sector penned a letter to President Donald Trump and Vice President Mike Pence in an effort to maintain federal support for value-based care and MACRA implementation.

Among some notable names among 121 healthcare organizations subscribed to the letter are provider associations (e.g., American Hospital Association, American Medical Association, American Academy of Family Physicians, health systems (e.g., Anthem, Cleveland Clinic, Partners HealthCare), payers (Aetna, Blue Cross Blue Shield), health IT companies (e.g., athenahealth, McKesson, Surescripts) — among many others.

The main focus of the letter to the Trump administration was to enumerate ten principles the alliance of healthcare organizations considers essential to achieving a “modernized, sustainable healthcare system.”

The ten policy principles these organizations center of elements of value-based care:

  1. Empowering patients to make informed healthcare decisions with support from their healthcare team.
  2. Investing in engaging patients in the development of measures on provider performance and ensuring these measures are reported by all public and private payers.
  3. Improve clinician and provider access to claims data to ease patient care management.
  4. Acknowledge the socioeconomic status of many patients impedes their ability to receive quality care and adjust payments appropriately.
  5. Design and adjust payment models so they offer a reasonable return on investment and support high-value services at a reduced cost based on patient choice and competitive markets.
  6. Extend the use of waivers from fee-for-service legal and regulatory requirements that obstruct collaboration and shared accountability while ensuring patient protections and security measures against fraud.
  7. Expand payment models that promote collaborative financial and care coordination arrangements using incentives that suit payers, healthcare providers, providers of long-term care services, and clinicians.
  8. Incentivize access to medical advancements and treatments with the potential to improve care quality and reduce overall system costs.
  9. Encourage public and private investment in transparent, evidence-based testing and scaling of new alternative payment models in alignment with MACRA regulations so providers and payers will understand payment models and their development and functionality in a clinical setting.
  10.  Promote alignment between private and public sector programs to facilitate a sustainable value-based payment marketplace.

 “As a purpose-driven organization, Aurora Health Care is committed improving the health and well-being of the people and communities we serve in eastern Wisconsin,” said Aurora Health Care President & CEO Nick W. Turkal, MD, in an accompanying public statement.

“As a participant in a Medicare ACO, we have achieved top performance in clinical quality, while sharing in associated cost savings with the federal government,” he continued. “We have also shared the insights we have gained nationally through Premier’s population health collaborative. We strongly believe that alternative payment models can effectively align incentives to improve clinical quality and reduce costs and have demonstrated this in our ACO performance.”

To educate others on these ten principles, the subscribing organizations hosted a briefing on value-based care in the Hart Senate Office Building on Wednesday afternoon.

“Through value-based models like the Perioperative Surgical Home, we are better managing care before, during and after a surgical procedure,” said Stead Health Group Vice President & Founder Stanley Stead, MD, MBA, ASA, added. “As a result, we’re reducing complications, readmissions and speeding up recovery times for patients. This is exactly the kind of experimentation that we must continue to invest in for the future.”

The move toward value-based care is already well-underway, with more than 359,000 clinicians in line to participate in APMs in 2017 as part of MACRA implementation. Moving forward, healthcare organizations aim to maintain this momentum with the new administration. 



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