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The American Heart Association, a global force for longer, healthier lives for all, is advocating for a shift away from the current health care payment system in the U.S., which is primarily based on fee-for-service, to a value-based payment (VBP) system. A VBP system is person-centered, equitable, coordinated and seeks to improve outcomes and experiences for patients and clinicians, while controlling costs.
Health care payers, including the U.S. Centers for Medicare and Medicaid Services (CMS), major employers and health insurance companies, are increasingly adopting new payment models based on quality of care and cost of care. In the new American Heart Association policy statement, “Value-Based Payment for Clinicians Treating Cardiovascular Disease,” the Association summarizes the current landscape of VBP for cardiovascular disease clinicians and outlines recommendations for increasing its adoption. The new policy statement published today in the Association’s flagship, peer-reviewed scientific journal, Circulation.
In the traditional fee-for-service system, clinicians are paid based on the number of services provided, which does not include consideration for quality of care, patient outcomes or resource utilization. In a VBP system, improved quality and outcomes are the focus.
“Value-based care delivery and payment models hold the promise of producing better patient outcomes and lowering costs,” said Karen E. Joynt Maddox, M.D., M.P.H., FAHA, vice chair of the policy statement, a member of the American Heart Association’s Advocacy Coordinating Committee and an assistant professor of medicine at Washington University in St. Louis in St. Louis, Missouri. “Value-based programs represent an important but under-recognized opportunity to improve the clinician’s experience and the efficiency, quality and value of patient care.”