Complimentary from the publisher

Complimentary from the publishers of VBP News June 2020

"As we’ve seen from the COVID-19 pandemic, providers in value-based care models like ACOs have been better positioned to handle patients and withstand drops in revenue than those purely in fee-for-service."
-Clif Gaus, ScD, president and CEO of The National Association of ACOs

In its final evaluation of Maryland’s All-Payer Model, which was introduced in 2014, the Centers for Medicare and Medicaid Services found that Medicare spending fell 2.8% relative to a comparison group, producing $975 million in savings, driven by a 4.1% reduction in total hospital expenditures.

Source: Milbank Memorial Fund, June 15, 2020

How cutting off subsidy payments to insurance companies would affect Obamacare

The Fundamental Shift to Value Base Care

The first video in a 3-part series from The Learning and Diffusion Group at the Center for Medicare & Medicaid Innovation (CMMI) provides an overview of value-based payment reform as compared to traditional fee-for-service. This video showcases former Chief Medical Officer, Hyong (Ken) Kim, MD, from CMMI as he sits down with Rushika Fernandopulle, MD, a value-based care thought leader and CEO of Iora Health.

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	John Rezen: 7 steps toward a value-based payment model for primary care 1. Establish true patient panels for each primary care physician. 2. Agree on the optimal percentage of the healthcare dollar that should go for primary care. 3. Adjust each primary care team’s payments to account for the overall health status of the patient panel. 4. Set targeted performance levels for quality based on primary care scores under the Merit-based incentive payment system (MIPS). 5. Use national primary care patient satisfaction benchmarks to agree on targeted performance levels for service. 6. Use current regional healthcare per-member-per-month (PMPM) costs adjusted by the patient-panel-specific RAF score to set a total cost baseline for each primary care team. 7. Determine the total value of primary care payments for the period of service. Note: John Rezen, MHA, LSSBB, CRCR, is president and CEO, Value Health, Pinehurst, N.C., and a member of HFMA’s North Carolina Chapter. Source: HFMA, June 11, 2020

Washington DC Watch: CMS Ups Medicaid Plans’ Ability to Base Payment on Drugs’ ‘Clinical Value’; NAACOS ‘Wholeheartedly Agrees’ With MedPAC Report
Stakeholders Stake Out Positions Anticipating Release of OCF Details
Industry News with briefs regarding Independence Blue Cross and Children’s Hospital of Philadelphia; Aledade
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