Medicare has introduced several alternatives to the traditional payment system such as Accountable Care Organizations, Hospital Value-Based Purchasing, Hospital Readmission Reduction Program and other quality measured payment methods over the last few years. Currently, 20% of total Medicare payments are provided by these alternative payment methods. Medicare has set new goal dates and percent of use of these alternative payment methods as:
• 2016 30% payment by alternative payment methods
• 2018 50% payment by alternative payment methods
Medicare plans to tie larger portions of the hospital payments (85%) to the value based and quality programs with a 90% increase in 2018. This is the first time Medicare has set goal dates and percentage amounts to change the traditional fee-for-service model. Medicare plans to change the traditional economic incentives to outcome based incentives.
HHS has created the Health Care Payment Learning and Action Network to move value-based payment models to the health insurance market, including employer-based coverage and state Medicaid programs.
GIRS can assist you with tracking these payment changes and monitoring the activities of the Health Care Payment Learning and Action Network.
Source: http://www.modernhealthcare.com/article/20150126/NEWS/301269811