APMs | VBCExhibitHall Library

Value-Based Payment Models Associated with Lower Acute Care Use

March 22, 2022acoAPMs, FFS, MA, Medicare Advantage, Physician Compensation, value-based payment

Medicare Advantage beneficiaries whose primary care organization participated in a value-based payment model saw lower rates of hospitalizations, observation stays, and emergency department visits, according to a study published in JAMA Network Open. Value-based payment models incentivize providers to deliver quality care while keeping healthcare spending low. As stakeholders see positive results, Medicare and Medicare Advantage plans have shifted toward…

NAACOS, APG Urge HHS to Adjust Direct Contracting Model, Not Cancel

February 16, 2022acoAMA, APMs, CMMI, congress, DCEs, direct contracting, FFS, HHS, NAACOS

More than 200 healthcare organizations, including America’s Physician Groups (APG) and the National Association of ACOs (NAACOS), have urged the Department of Health and Human Services (HHS) to make adjustments to the Global and Professional Direct Contracting Model instead of canceling the program. In a letter to HHS Secretary Xavier Becerra, the groups stressed that shutting down the Direct…

Provider Collaboration Needed to Drive Patient Experience, ACO Success

February 9, 2022acoAPMs, direct contracting, FFS, Interoperability, provider collaboration

In order to ensure accountable care organization (ACO) and patient experience success, providers must collaborate across the continuum of care, suggested a recent study out of the Ohio State University Fisher College of Business. “We found that if an ACO wants to be successful, it needs representation across all parts of a patient’s continuum of care,”…

NAACOS, AMA Urge Congress to Boost Value-Based Care, APM Incentives

February 4, 2022acoAMA, APMs, congress, NAACOS

A group of eight healthcare organizations, including the American Medical Association (AMA) and National Association of ACOs (NAACOS), have asked Congress to increase their efforts in promoting value-based care and alternative payment model (APM) adoption. In a letter sent to the Senate Committee on Finance Subcommittee on Fiscal Responsibility and Economic Growth, the organizations highlighted…

Volume vs. value: Physician compensation models slow to adapt

February 2, 2022acoAPMs, FFS, Physician Compensation, value-based payment

Despite the promise of value-based care, the current compensation structure continues to incentivize physicians for volume. A payment hierarchy exists in the U.S. health care system. Reimbursement mechanisms used by payers create incentives for health systems and physician organizations. In turn, these organizations create incentives for physicians through compensation packages, which may or may not…

Physician Compensation Still Hinges on Volume at System-Owned Practices

February 1, 2022acoAPMs, FFS, Physician Compensation, value-based payment

Despite a decades-long push toward value-based payment, physician compensation arrangements at health system-owned practices still primarily revolves around the volume of services delivered, according to a new study from RAND Corporation. The study recently published in JAMA Health Forum examined physician compensation structures at 31 physician organizations affiliated with 22 health systems in four states….

Most health systems still base doctors’ pay on volume, despite push toward value-based care: study

January 28, 2022acoalternative payment models, APMs, fee-for-service, FFS, value-based care, value-based payment, vbc

Despite the growth in value-based payment arrangements from payers, health systems continue to pay physicians based on the volume of services they provide. A new study published in the journal JAMA Health Forum finds that volume-based compensation was the most common type of base pay for more than 80% of primary care physicians and for more…

The Perils and Payoffs of Alternative Payment Models for Community Health Centers

January 18, 2022acoalternative payment models, APMs

In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. CMMI considers APMs to be any arrangements whereby providers are held accountable for the quality and costs of care,…

Over 50 Lawmakers Urge Administration to End Direct Contracting

January 17, 2022acoAMA, APMs, CMMI, congress, DCEs, direct contracting, FFS, HHS, NAACOS

The lawmakers claim direct contracting is a Trump-era privatization tactic that has removed millions of seniors from Traditional Medicare without their knowledge or consent. More than 50 lawmakers led by US Representative Pramila Jayapa urged the Biden administration to discontinue the Medicare Direct Contracting (DC) program and transition Medicare beneficiaries into the Traditional Medicare model. In a letter written to HHS…

Hierarchical Payment Models—A Path for Coordinating Population- and Episode-Based Payment Models

January 14, 2022acoalternative payment models, APMs, Bundled Payments, CMS, value-based payment

In November 2021, the Centers for Medicare & Medicaid Services (CMS) announced a strategy to achieve near-universal participation in value-based payment models by 2030. Core to this strategy is the goal that every beneficiary should be in a clinical care relationship that has accountability for quality and total cost of care. Achieving this goal will…