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HHS sets goals to move from volume- to value-based Medicare payments

by Lauren Dubinsky, Senior Reporter | January 27, 2015
Department of Health
and Human Services
The U.S. Department of Health and Human Services announced yesterday that it is establishing a clear timeline to move from volume- to value-based Medicare payments. The agency will be using benchmarks and metrics to measure its progress.

Its first priority is to have it so that 30 percent of all Medicare provider payments are paid based on alternative models that consider the providers' quality of care by 2016. Once that is achieved, it would like to get that number to 50 percent by 2018.

The alternative payment models include Accountable Care Organizations, Patient Centered Medical Home model and the "bundled payment" model.

The agency's second goal is for almost all Medicare fee-for-service payments to be linked to quality and value. It hopes that it will be true for 85 percent of payments in 2016 and 90 percent in 2018.

"Our goal here is to move away from the old way of doing things, which amounted to, 'the more you do, the more you get paid' by linking nearly all payment to quality and value in some way to see that we are spending smarter," Sylvia Matthews Burwell, HHS secretary, said in a statement.

The agency also announced yesterday that it created the Health Care Payment Learning & Action Network to assist with the public-private sector partnership. It reported that people have expressed interest in joining. The first meeting will be held in March.

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