Medicare's Shift to Value-Based Reimbursement

Medicare's Shift to Value-Based Reimbursement

Last week's repeal of the Medicare Sustainable Growth Rate by Congress and subsequent approval by President Obama has strengthened the healthcare industry's move toward value-based physician reimbursement.

Previously, this year CMS had released measurable goals and a timeline to move the Medicare program toward paying providers based on the quality, rather than the quantity of care they give patients.

HHS had set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.

HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs.

HHS will intensify its work with states and private payers to support adoption of alternative payments models through their own aligned work, sometimes even exceeding the goals set for Medicare.

Given CMS' ambitious timeline for rewarding value-based care, healthcare organizations can no longer afford to ignore the industry's inevitable shift to value-based reimbursement.

HIN.com has a range of resources to get you up to speed on the most successful strategies for value-based reimbursement, including:

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