In a letter to Congress and the Administration, leading healthcare organizations today called for a renewed effort to move to value-based care, patient-centered payment models that reward improved quality and cost-effective care. Central to this effort is addressing the perverse incentives in the fee-for-service system, and antiquated laws and regulations that impede innovation and care coordination.
The bipartisan journey toward value-based care began more than 15 years ago with pay for performance, bundled payment and accountable care organization (ACO) models. Healthcare providers, clinicians and insurers have invested significantly in moving healthcare in this direction. Policy changes and payment model improvements are critical to strengthen and expand on this movement, which is starting to generate results. For instance, Medicare ACOs have collectively generated $1.29 billion in savings since 2012 while improving quality.
As policymakers debate the direction of federal healthcare policy, signers of the letter recommended 10 principles to build momentum behind value-based care and shift incentives away from a reactive healthcare system to one that is centered on the patient’s health, high-quality and cost-effective care. Supporters include the American Society of Anesthesiologists (ASA), Healthcare Leadership Council (HLC), Health Care Transformation Task Force (HCTTF), National Coalition on Health Care (NCHC) and Premier Inc., as well as more than 120 co-signers representing clinicians, employers, labor unions, hospitals, pharmacists, consumer groups, biopharmaceutical companies and insurance carriers.
The ten key principles to support a modernized, sustainable healthcare system through value-based care include:
1. Empower and engage patients to make healthcare decisions with information and support from their healthcare team.
2. Invest in engaging patients in the development of measures of provider performance that are relevant to them and consistently and transparently reported by all public and private payers.
3. Improve clinician and provider access to timely, accurate and complete claims data to better facilitate care management.
4. Recognize that the socioeconomic status of many patients creates challenges in providing care, and adjust payments to providers as appropriate.
5. Design voluntary payment models that incent greater participation and achieve the highest quality and cost value based on patient choice and competitive markets.
6. Expand the use of waivers from fee-for-service legal and regulatory requirements that impede collaboration and shared accountability, while preserving consumer protections and safeguards against fraud.
7. Build on and expand payment models that promote collaborative financial and care coordination arrangements using incentives that align payers, healthcare providers, providers of long-term care services and clinicians.
8. Appropriately incent access to medical innovations and treatments that hold the potential to improve quality of care and reduce overall system cost.
9. Promote public and private investment in the transparent, evidence-based testing and scaling of new alternative payment models as directed in MACRA so that clinicians, other healthcare providers and payers can learn how payment models work and evolve in the clinical setting.
10. Ensure alignment between private and public sector programs, which is critical to a sustainable value-based payment marketplace.
“I am confident that the migration toward value-based care will continue regardless of what happens in the next few months,” said the Honorable Michael O. Leavitt, chairman and co-founder, Leavitt Partners, three-term governor of Utah and former U.S. Secretary of HHS in a statement. “There is a remarkable amount of bipartisan agreement when it comes to payment and delivery reforms, as evidenced by legislation like MACRA, and the Republican Congress has established a clear pattern of supporting the transition from fee-for-service to value payment.”
In support of the 10 principles, the sponsoring organizations are hosting an educational briefing on value-based care today at 2:30 p.m. EST in the Hart Senate Office Building, room 902. Moderated by Blair Childs, senior vice president of public affairs at Premier, speakers include Gov. Leavitt; Kevin Klobucar, executive vice president of healthcare value at Blue Cross Blue Shield Michigan; Stanley Stead, MD, MBA, ASA vice president for Professional Affairs and CEO and founder, Stead Health Group, Inc.; Nick W. Turkal, MD, president and CEO, Aurora Health Care; and Bill Kramer, executive director, National Policy, Pacific Business Group on Health.