CMS Announces Reimbursement Shift from Volume to Value
Medicare will rapidly shift to payments based on quality rather than quantity, according to a January 26 announcement.
By the end of 2016, Medicare aims to pay 30% of its fee-for-service dollars through alternative payment models such as Accountable Care Organizations (ACOs) or bundled payment. That goal rises to 50% in 2018.
Medicare also aims to tie 85% of all traditional Medicare payments to quality or value by 2016 and 90% by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reductions Programs. A minority of Medicare's payments are currently tied to quality or value.
A Health Care Payment Learning and Action Network will help expand alternative payment models into commercial, employer, and Medicaid programs.
To date, pilots of alternative payment models have saved Medicare $17 million. Hospital readmissions have decreased nearly 8%, translating to 150,000 fewer readmissions between January 2012 and December 2013. Quality improvement efforts saved 50,000 lives and $12 billion in health spending from 2010 to 2013.
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