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Arnold Ventures: What’s Next for Payment Reform

By April 12, 2022April 25th, 2022No Comments

From Arnold Ventures:

The United States’ health care system is inefficient and often fails to deliver high-quality, patient-centered care. A key driver of this problem is the predominant way we pay providers. The fee-for-service (FFS) payment system reimburses health care providers based on the volume and type of services they perform, rather than on whether they improve care for patients. Alternatives to FFS—so-called “alternative payment models” (APMs)—can help solve this problem by giving providers stronger incentives and greater flexibility to efficiently deliver patient-centered care that improves population health. These models include accountable care organizations (ACOs), which hold providers accountable for the total cost and quality of care.

The Center for Medicare & Medicaid Innovation (CMMI) recently underscored a renewed commitment to advancing the adoption of ACOs and similar models in its Strategy Refresh, reinvigorating interest in payment reform among the health policy community. With aspirations to have all Medicare FFS beneficiaries in ACOs or similar accountable care models by the end of this decade, CMMI can play an important role leading the transformation of our health care system and patient care, but there is still a lot of work to be done to realize the promise of payment reform.

To reflect on the current state of payment reform and explore where we are headed, Arnold Ventures sat down with leading health care expert Dr. Amol Navathe, assistant professor of health policy at the University of Pennsylvania Perelman School of Medicine and current commissioner of the Medicare Payment Advisory Commission (MedPAC), a non-partisan agency that advises Congress on Medicare policy. Dr. Navathe’s work is rooted in his experience as a practicing physician where he navigates the challenges of our FFS system and sees the promise of APMs.

Read more at Arnold Ventures.

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