Value-Based Models Flex Their Muscles

Twenty-five percent of total Medicaid, Medicare Advantage, and commercial payments this year were made to health care providers in alternative payment models (APMs) such as ACOs and bundled payments. Medicare Advantage saw the biggest gain, with 41% of MA payments being made to APMs, according to a report by HHS’ Health Care Payment & Action Network. It’s in keeping with the goal that CMS set for itself last year of having half of Medicare outlays go through APMs tied to value by the end of 2018.

Researchers say that value-based models increased cooperation between plans and providers and helped to reduce inpatient hospitalizations and readmission rates. They also improved quality and appropriate use.

Source: Health Care Payment & Action Network