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2015-01 HHS Sets Clear Goals and Timeline for Shifting Medicare Reimbursements from Volume to Value





HHS Sets Clear Goals and Timeline for Shifting Medicare Reimbursements from Volume to Value: Better, Smarter, Healthier
  • On January 26, in a meeting with nearly two dozen leaders representing consumers, insurers, providers, and business leaders, HHS Secretary Sylvia M. Burwell announced measurable goals and a timeline to move the Medicare program, and the health care system at large, toward paying providers based on the quality, rather than the quantity of care they give patients.
  • HHS has 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. This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.
  • To make these goals scalable beyond Medicare, Secretary Burwell also announced the creation of a Health Care Payment Learning and Action Network. Through the Learning and Action Network, HHS will work with private payers, employers, consumers, providers, states and state Medicaid programs, and other partners to expand alternative payment models into their programs. HHS will intensify its work with states and private payers to support adoption of alternative payment models through their own aligned work, sometimes even exceeding the goals set for Medicare. The Network will hold its first meeting in March 2015, and more details will be announced in the near future.
  • For more information:
    Article in the New England Journal of Medicine by Secretary Burwell: Setting Value-Based Payment Goals — HHS Efforts to Improve U.S. Health Care
    Fact Sheet: Better Care. Smarter Spending. Healthier People: Why It Matters
    Fact Sheet: Better Care. Smarter Spending. Healthier People: Paying Providers for Value, Not Volume
    Fact Sheet: Better Care, Smarter Spending, Healthier People: Improving Our Health Care Delivery System

Full text of this excerpted HHS press release (issued January 26).