CMS Meets Goal for Promoting Value over Volume

Added on Mar 21, 2016

CMS Meets Goal for Promoting Value over Volume
From Industry Edge March 2016

More than 30% of Medicare Part A and Part B payments were attributed to alternative payment models (APMs) as of January 1, 2016, according to the Centers for Medicare & Medicaid Services (CMS). This milestone, which CMS reached one year ahead of schedule, follows the U.S. Department of Health & Human Services’ challenge in February 2015 to shift health care payments toward quality rather than quantity.

Stating that true transformation of the health care system in the United States “cannot be done through Medicare alone,” CMS added that it “looks forward to continuing to work with partners across the country to achieve the goals of tying 30% of spending to APMs by the end of 2016 and 50% by the end of 2018.” According to CMS, the traditional fee-for-service Medicare payments will be tied to quality using existing APMs, such as accountable care organizations (ACOs) and bundled payment arrangements, which were set up in large part through the Affordable Care Act (ACA).

Almost all APMs comprise measures of quality — including patient experience measures — gathered under Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys. Examples include the ACO CAHPS for Medicare Shared Savings Program (MSSP) model and the In-center Hemodialysis (ICH) CAHPS for Comprehensive ESRD Care model.