New goals set for value-based payments

The Health Care Payment Learning and Action Network, a public-private partnership launched by HHS in 2015, has set new goals for linking healthcare payments to the value of care provided rather than the amount of care provided. 

The network announced the new goals for shared accountability alternative payment models Oct. 24. They are based on models that include downside financial risk in the LAN Alternative Payment Model Framework, which represents payments from government and private insurers to healthcare providers.

The new goals for adoption of shared accountability alternative payment models are:

  • Medicare Advantage and traditional Medicare (30 percent adoption by 2020, 50 percent by 2022 and 100 percent by 2025)
  • Medicaid (15 percent adoption by 2020, 25 percent by 2022 and 50 percent by 2025)
  • Commercial health plans (15 percent adoption by 2020, 25 percent by 2022 and 50 percent by 2025)

The new goals come as the network sees progress in shifting to value-based healthcare payments.

The LAN examined data from 62 health plans and seven states representing about 227 million Americans and 77 percent of people covered through commercial health plans, Medicare Advantage, traditional Medicare or Medicaid.

Network representatives found that 35.8 percent of U.S. healthcare payments in 2018 were made through alternative payment models including upside and downside risk.

In 2017, 34 percent of U.S. healthcare payments were tied to alternative payment models including upside and downside risk, according to network representatives.

More information is available here.

 

More articles on healthcare finance: 

Hospital leaders express concerns about Massachusetts healthcare cost-cutting bill
Pennsylvania hospitals see boost in ER visits, admissions amid Hahnemann closure
Hospitals increasingly serious about cost transformation, survey finds

 

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