U.S. Department of Health and Human Services (HHS), Secretary Burwell, announced in late January, explicit details on how the American health-care system will transition from fee-for-service reimbursement to alternative payment models as a critical step toward:
Better care, smarter spending and healthier people
This is the first time in the history of the US health care system to move from payment for volume to payment for value. Value is identified through quality measures – currently under review through the
National Quality Forum. Value, that comes through the use and implementation of current evidence and use of clinical practice guidelines.
HHS’s Advanced Payment Reform plans to modify 30% of fee-for-service claims by the end of 2016 by employing alternative payment models: Accountable Care Organizations (ACOs), primary care medical homes and bundled payments, like this year’s chronic care reimbursement model – planned for over 50% of value based reimbursement by 2018.
HHS will use the current Hospital Based Purchasing and Hospital Readmissions Reductions Programs, to transition by 85% for all Medicare reimbursement in 2016 and up to 90% by 2018.
How prepared are you for these changes?
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