Premier, others urge HHS to move forward on alternative payment models to achieve equity
The organizations recommended HHS build in flexibilities and payment for APM participants to strengthen their focus on addressing inequities.
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Premier joined 16 other national healthcare organizations in urging Department of Health and Human Services Secretary Xavier Becerra to move forward on alternative payment models as part of its strategy to achieve health equity.
In a letter sent to Becerra, the groups underscored how APMs routinely leverage multidisciplinary approaches to care, assess social risk, partner with community organizations to increase access to nonmedical services and leverage data to improve disparities in patient outcomes.
WHAT'S THE IMPACT?
To support and accelerate these efforts, the organizations recommended that HHS build in flexibilities and payment for APM participants to strengthen their focus on addressing health inequities, such as incorporating social determinants of health into risk adjustment.
The groups also advocated for ensuring thresholds can reasonably be met for clinicians to receive bonuses for participating in risk-bearing APMs, to encourage clinicians to remain in or join these programs.
Additionally, the organizations want HHS to set a clear plan for moving beyond testing to scaling the best approaches so that healthcare providers are eager to invest in these innovative models, develop a stable suite of models that help clinicians advance through the value-based continuum over time and provide greater technical support to APM participants to reduce the burden associated with model participation.
Notably, the letter also calls on the agency to address overlap in value-based care programs to remove conflicting incentives, align the goals of improving quality and outcomes and ensure providers are not disadvantaged for participating in multiple models.
Lastly, the signees pushed for HHS to utilize the Medicare Shared Savings Program – which generated $1.9 billion in net savings to Medicare in 2020 alone and had an average quality score of almost 99% – as an innovation platform.
The letter was signed Aledade, Alliance for Technology Driven Health, American Academy of Family Physicians, American College of Physicians, American Medical Association, American Medical Group Association, America's Essential Hospitals, America's Physician Groups, Association of American Medical Colleges, Caravan Health, Evolent Health, Health Care Transformation Task Force, National Association of ACOs, Medical Group Management Association, Partnership to Empower Physician-Led Care, Premier healthcare alliance, and Value Based Care Coalition.
THE LARGER TREND
The Value in Health Care Act, introduced in July, was praised by the AMA, AHIP and others as a means to accelerate the move to value-based payments and alternative payment models.
The bill increases Medicare Shared Savings rates, updates risk adjustment rules, eliminates the artificial distinction between "high" and "low" revenue ACOs, addresses ACOs' "rural glitch," and restarts the ACO Investment Model, according to the National Association of ACOs and other groups.
The bill also reinforces the shift to value-based care by extending the 5% Advanced APM incentive payments for an additional six years and authorizing a study of the overlap of various Medicare alternative payment models.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
