Re­port to mea­sure Medi­care’s pay­ment re­form progress

Modern Healthcare - - THE WEEEK AHEAD - —Sabriya Rice and Me­lanie Evans

A ma­jor em­ployer pur­chas­ing group will re­port this week on how much Medi­care ac­tu­ally spends on value-based care, even as HHS has promised to greatly ex­pand that pay­ment model.

The Berke­ley, Calif.-based Cat­a­lyst for Pay­ment Re­form says its May 5 re­port should serve as a bench­mark for eval­u­at­ing Medi­care’s ef­forts to re­ward providers through mod­els such as shared sav­ings, accountable care or­ga­ni­za­tions, bun­dled pay­ments and pa­tient-cen­tered med­i­cal homes.

“There is so much pay­ment re­form and in­no­va­tion hap­pen­ing right now,” said Ni­cole Koh­leriter-Perel­man, the group’s com­mu­ni­ca­tions direc­tor. “With this re­port, we will have more in­for­ma­tion about how Medi­care is pay­ing for health­care and the types of mod­els it uses.” The re­port in­cludes data dat­ing to 2013. The group, which rep­re­sents large public- and pri­vate-sec­tor em­ploy­ers and health­care pur­chasers, has re­leased com­mer­cial-sec­tor score­cards for the past two years. Tues­day’s re­port will be its first spe­cific look at Medi­care.

On Fri­day, CPR re­leased a re­view of value-based pay­ments by com­mer­cial in­sur­ers and Med­i­caid for providers in New York state. It found 94% of com­mer­cial pay­ments and 72% of Med­i­caid pay­ments still flow through fee-for-ser­vice.

Koh­leriter-Perel­man said her group’s mem­bers, in­clud­ing Boe­ing, Home De­pot, and public-em­ployee re­tire­ment sys­tems in Cal­i­for­nia and Ohio, share the de­sire for “qual­ity health­care for their em­ploy­ees at more af­ford­able prices.”


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