The Future of Value-Based Care Relies Upon Providers: Taking the Reins on Alternative Payment Models

By CHUCK SAUNDERS and NEAL SHORE, MD 2017 was a pivotal year for the growth of value-based care. For many practices, this meant completing their first performance year as part of the Merit-Based Incentive Payment System (MIPS). A much smaller percentage of practices was able to participate in approved advanced Alternative Payment Models (APMs). While practices await feedback on their 2017 performance, early lessons have already become evident. Clearly, as practices are assigned greater responsibility and accountability for patient populations, it becomes increasingly important that they effectively navigate the reimbursement models upon which their financial viability depends. Where should provider practices start? The MIPS model may not be a long-term answer. MedPAC has recently clearly articulated their disfavor with MIPS and desire to replace it. In contrast, advanced APMs provide a much more fertile ground for providers to work collectively. They can contribute their unique clinical expertise to define opportunities to improve quality and cost, focused on areas that have potentially greater beneficial impact on patient care and practice pathways. The Center for Medicare and Medicaid Innovation (CMMI) recently acknowledged as much by unveiling the Bundled Payments for Care Improvements (BPCI) effort that measures performance and sets payment against four broadly defined models of care. Per CMS, APMs in general refer to payment approaches that provide financial incentives ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs