25% of reimbursement tied to alternative models in 2016, study finds

About one in four payments for healthcare services in private and public markets were tied to alternative payment models in 2016, according to a report from the Health Care Payment Learning & Action Network.

In March, HHS declared that an estimated 30 percent of Medicare fee-for-service payments were tied to alternative payment models. LAN's study attempts to estimate the adoption rate of alternative payment models nationally across commercial, Medicare Advantage and state Medicaid market segments.

To quantify the adoption of alternative payment models nationwide, LAN collected contract data from 40 health plans representing more than 128 million covered lives, or nearly 44 percent of the combined commercial, Medicare Advantage and Medicaid markets. The study also assessed healthcare spending as of January 2016 across the aforementioned three markets.

Here are four quick findings.

  1. The study found about 25 percent of healthcare dollars were tied to alternative payment models in 2016, up from 23 percent in 2015.

  2. About 22 percent of commercial healthcare dollars were tied to alternative payment models in 2016.

  3. About 41 percent of Medicare Advantage healthcare dollars were tied to alternative payment models in 2016.

  4. About 18 percent of Medicaid dollars were tied to alternative payment models in 2016.

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