Health Information Management

News: Renewed emphasis on payment for quality of care

CDI Strategies, February 5, 2015

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Department of Health and Human Services Secretary Sylvia Burwell announced last week plans to ramp up Medicare payment reforms featuring alternative payment models and value-based payments.

"Whether you are a patient, a provider, a business, a health plan, or a taxpayer, it is in our common interest to build a healthcare system that delivers better care, spends healthcare dollars more wisely and results in healthier people," Burwell said. "We believe these goals can drive transformative change, help us manage and track progress, and create accountability for measurable improvement."

Although the idea of tying government healthcare reimbursement to efficiency and quality of care is nothing new, the aggressive plans outlined by Burwell and HHS are (click here to read the complete release.) They call for a three-year plan boosting the percentage of fee-for-service Medicare reimbursements based on alternative payment models (APM) and increasing the percentage of all reimbursements linked to quality and value, HealthLeaders Media reported.

The plan calls for Medicare fee-for-service payments through APMs—programs such as Hospital Value-Based Purchasing (VBP) program and the Hospital Readmission Reduction Program (HRRP)—to rise from the current 20% level to 30% by the end of 2016. The percentage is slated to rise to 50% by the end of 2018. It additionally calls for the percentage of Medicare payments that are linked to quality and value to reach 85% by 2016 and 90% by 2018. 

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