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…
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….
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…
Medicare population-based payment models, broadly known as accountable care organization (ACO) models, of which the Global and Professional Direct Contracting Model (GPDC) is an example, were launched out of recognition of two largely inherent weaknesses of fee-for-service: FFS does not promote efficiency, nor does it promote equity. The Centers for Medicare and Medicaid Services (CMS)…
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…
Most healthcare payments made in 2020 were tied in some way to value or quality of care, according to the latest data from the Health Care Payment Learning & Action Network (LAN). The LAN’s latest APM Measurement report showed that 40.9 percent of US healthcare payments, representing approximately 238.8 million Americans and over 80 percent…
Medicare Advantage plans offer members additional benefits and require less spending from the federal government compared to fee-for-service (FFS) Medicare, according to a report commissioned by Better Medicare Alliance’s Center for Innovation in Medicare Advantage. The management consulting company Milliman conducted the report by analyzing FFS Medicare and Medicare Advantage cost, enrollment, and benefit data from CMS…
Accountable Care Organizations (ACOs) have been around for more than a decade—created with the idea that integrating care providers across settings (hospitals, primary care, specialty care, etc.) and aligning their financial incentives would lead to improved clinical outcomes and lower healthcare costs. And indeed, some of the most effective and efficient healthcare organizations in the…
Two influential advisory groups sent recommendations to Congress calling for a revamp of how health plans are paid in the lucrative Medicare Advantage program, culling how many models CMS tests and curbing high-cost drug approvals. By many measures, the MA program has been thriving. Enrollment and participation has continued to grow, and in 2021, MA…
Earlier this month, Premier hosted a panel on value-based care (VBC), with providers from across the healthcare continuum discussing its merits and pitfalls. In attendance were members of Congress and their staffers to hear how precisely VBC has been effective and policy changes needed to continue its forward progress. One message came through above all…