Congress Is Getting the Transition to Alternative Payment Models Wrong

By TAYLOR CHRISTENSEN Alternative payment models (APMs) are a hot topic these days, and everyone seems to agree that we need to transition toward them and away from fee for service (FFS). But how should we do it? First, let’s think about this task as government policy makers would think about it. They would probably start by saying, “We need to find a way to give incentives to providers and payers to try out these different APMs.” This would be fairly easy to do through Medicare, so they would create some Medicare APM programs and structure them in a way that makes the benefits of joining large enough that lots of providers will want to participate. And for the sake of uniform provider incentives, they would also want to encourage private insurer-provider diads to start using APMs, preferably ones as similar to the Medicare APM programs as possible. And so they would probably have to offer private insurers and/or providers money to do so. These two approaches are what we’ve seen policy makers do. Medicare has a number of different APM programs. The best-known ones are the Medicare Shared Savings Program (to get providers to enter into ACO contracts with Medicare) and the Bundled Payments for Care Improvement initiative (to get providers to enter into bundled payment contracts with Medicare). And to encourage private insurer-provider diads to start using APMs as well, they have created a couple different initiatives: Medicare join...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy Alternative Payment Model TAYLOR CHRISTENSEN Source Type: blogs