Last week, Health and Human Services Secretary Sylvia Burwell announced a goal to shift 30% of payments to a pay-for-quality model by the end of 2016, ramping up to 50% by the end of 2018. You can view their official announcement by clicking here. This is the first time HHS has announced a measurable timeline for this shift in payment models.
In traditional payment models, clinicians have been compensated for the volume of services provided, regardless of the necessity or effectiveness. Progressive models created under the Affordable Care Act call for clinicians to get paid not only for necessary treatments, but more for those that work.
“Whether you are a patient, a provider, a business, a health plan, or a taxpayer, it is in our common interest to build a health care system that delivers better care, spends health care dollars more wisely and results in healthier people. Today’s announcement is about improving the quality of care we receive when we are sick, while at the same time spending our health care dollars more wisely,” Secretary Burwell said. This goal of happier and healthier patients, coupled with reduced health care spending, is often referred to as the Triple Aim.
Medicare aims to accomplish these goals by embracing alternative payment models such as payment for quality or value through vehicles like Accountable Care Organizations (ACOs). To assist clinicians and private payers in this transition, HHS has created a Health Care Payment Learning and Action Network. Through this program, HHS will work with states and health plans to aid them in the transition to the new payment models. The network expects to hold its first meeting in March 2015.
Valant has certainly marched to this drum-beat because initial results have been promising. Today, 20% of Medicare payments already use alternative payment models. According to HHS’ preliminary estimates, this has resulted in $12 billion saved in health spending and 50,000 lives saved.
This plan and its cost-saving goals apply across multiple settings of care, including private practices, public agencies, and hospitals. As Janet Marchibroda, Health Innovation Director and Executive Director of the CEO Council on Health and Innovation at the Bipartisan Policy Center said, “There is considerable bipartisan support for moving away from fee for service toward alternative payment models that reward value, improve outcomes, and reduce costs. This transition requires action not only by the private sector, but also the public sector, which is why today’s announcement is significant.”
While this news applies to all Medicare providers regardless of specialty, at Valant we’re thinking ahead to what this announcement means specifically for our behavioral health professionals. As these value-based policy incentives continue to come online, behavioral healthcare organizations will have to focus more time on management, tracking, compliance, and demonstrating quality-of-care. Valant is already helping providers succeed in this new environment by delivering the technology and services tailored to their behavioral practices with our easy-to-use applications and professional services. By automating measurement to support evidence-based care, you can focus on improving the success of treatments and outcomes reporting, thereby allowing our specialty to effectively participate in ACOs.
How can you prepare? Valant can help!