US Senators John Barrasso (R-WY) and Sheldon Whitehouse (D-RI) have introduced a bipartisan bill that would extend value-based payment incentives for healthcare providers participating in Medicare’s alternative payment models (APMs). The Preserving Access to Value-Based Care Act will extend the 5 percent advanced APM incentive payment for an additional two years. In addition, the bill…
Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from fee-for-service models and toward value-based care models, CMS has implemented several programs to improve patient care, advance population health, and lower healthcare costs. These value-based…
Value-based payment models that shared five-year expected savings offered stronger incentives for clinicians to implement preventive interventions for postpartum depression compared to models that offered shared savings over just one year, according to a study published in JAMA Network Open. The Affordable Care Act requires most commercial health insurance plans to cover preventive services for pregnant or postpartum…
The Center for Medicare and Medicaid Innovations (CMMI) recently announced the ACO Realizing Equity, Access, and Community Health (REACH) Model. The REACH Model will replace the Direct Contracting model starting on 1/1/23. ACO REACH retains the DC Model Global and Professional tracks and adds new requirements to advance equity, promote provider governance, and protect beneficiaries….
New bipartisan legislation introduced in the House aims to reform Medicaid to enable the use of value-based purchasing agreements in Medicaid. The Medicaid VBP Act, released Tuesday, aims to ensure new treatments such as gene therapies would be administered under Medicaid via a value-based agreement that reimburses drug makers based on the outcomes the drug provides….
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…
Physicians who depend on reimbursement from CMS tangle with value based payment (VBP) systems, a regulatory framework intended to hold providers accountable for healthcare quality and cost. CMS promotes these systems as providing better care for individual patients, better health for populations, and lower costs compared with the traditional fee-for-service (FFS) model. In many ways,…
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…