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I spent most of my space in last week’s blog post thanking AHIP for saving the annual progress report on alternative payment model (APM) adoption from the clutches of the Centers for Medicare and Medicaid Services (CMS) and the Make America Healthy Again movement. I spent the balance of the post on some interesting data from the report on how much money still flows from payers to providers via traditional fee-for-service reimbursement contracts.
I’m going to pick up where I left off because I ran out of room to tell the entire story.
AHIP’s APM Measurement Effort report is based on an analysis of claims data from commercial health plans, traditional Medicare, Medicare Advantage (MA) plans and state Medicaid programs. The analysis determines how much money those four payers pay to providers through four escalating categories of APMs with traditional fee-for-service models with no link to quality or value on the low end (Category 1) and four variations of population-based payment models on the high end (Category 4).