HHS hits goal of shifting 30% of Medicare payments to alternative models

HHS has reached its goal of tying 30 percent of Medicare payments to quality nearly 10 months ahead of schedule.

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In January 2015, HHS said it wanted 30 percent of all Medicare provider payments to fall under an alternative model, which includes accountable care organizations, patient-centered medical homes or bundled payments, by the end of 2016. On Thursday, HHS said it estimates that it has already achieved this goal.

“We reached this goal in partnership with the thousands of providers who collaborated with us in innovation,” said Patrick Conway, MD, deputy administrator for innovation & quality and CMO for CMS. “It’s in our common interest — as patients, providers, businesses, health plans, taxpayers — to build a healthcare delivery system that delivers better care; spends healthcare dollars more wisely; and makes individuals and communities healthier.”

As of January, CMS estimates that roughly $117 billion out of a projected $380 billion in Medicare fee-for-service payments are tied to alternative payment models.

CMS estimated progress toward the goal by multiplying the number of Medicare beneficiaries in alternative payment models by the expected cost of their care and compared that figure to projected Medicare fee-for-service spending.

Although the mark for 2016 has been met, the standard is higher in later years. By 2018, the benchmark is to have half of all Medicare provider payments fall under an alternative model.

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