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Industry Applauds HHS Commitment to Value-Based Reimbursements

By Jennifer Bresnick

The healthcare industry seems to be largely on board with HHS Secretary Sylvia Burwell’s plan to base the majority of Medicare’s payments on value-based reimbursements within the next few years.  The commitment to banish traditional fee-for-service payment models in an effort to contain mushrooming costs may be a turning point in the way healthcare providers view their role in providing quality, value, and better overall outcomes instead of treating specific symptoms or diseases for a flat rate.

“Today’s [Jan 26] announcement by the US Department of Health and Human Services aligns with the American Medical Association’s commitment to work toward innovative care delivery reform that will promote high-quality and efficient care for our nation’s seniors who count on Medicare, while reducing the administrative and regulatory burdens physicians face today,” said AMA President Robert M. Wah in a press release.

“We staunchly support efforts that will improve the information and data available to physicians so that they will have better information for better decisions about treatment plans for their patients, and we look forward to participating in the Learning and Action Network and working collaboratively to achieve the goals of improving health care delivery,” he added.  “We look forward to hearing more details behind the percentages HHS put forward as well as their plans to reach these percentage targets.”

Neither the AMA nor Senator Lamar Alexander (R-TN) could resist nudging Burwell to consider additional reforms to the healthcare payment system, with Wah urging a permanent repeal of the contentious sustainable growth rate (SGR) and Alexander promoting his own proposal to introduce reforms to Medicare and Medicaid.

“Moving away from fee-for-service payments is one step toward providing higher quality and lower costs for Medicare and Medicaid payments, but it is still important to enact benefit reforms, or seniors will not be able to count on Medicare paying their hospital bills,” Senator Alexander said. “One such reform proposal is the Fiscal Sustainability Act, which I introduced last Congress with Senator Corker to save nearly $1 trillion over the next ten years by reforming entitlements.”

On the heels of Burwell’s announcement, a group of payers and large providers called the Health Care Transformation Task Force have made their own pledge to increase reliance on value-based reimbursement and accountable care.  The coalition will attempt to transfer 75% of its business into value-based arrangements by 2020, providing HHS with private industry allies to further their mutual quest.

“The formation of this Task Force and its ambitious goal demonstrate that the private sector embraces a value-based approach to improving care and lowering costs,” said Richard J. Gilfillan, MD, CEO of Trinity Health, the Task Force’s chairman. “We are committed to rapid, measurable change both for ourselves and our country that will improve quality and make health care more accessible for all American families.”

“Building a healthier world requires fresh thinking and innovation. It calls for everyone in health care to rally around the single goal of improving health and service while reducing costs – whether you give care, receive care, manage care, or pay for care,” added Fran Soistman, Executive Vice President of Government Services at Aetna. “This Task Force brings together a cross section of leaders, working together to find better ways to improve the health of people and communities. By joining together, we are well positioned to introduce more effective change, more quickly, with more impactful results.”





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