CHICAGO — Whether it is moving to alternative payment models or pushing for greater information-sharing, federal officials reiterated their intention to use the powers at their disposal — regulatory and voluntary — to prod providers and vendors toward better care, smarter spending and healthier people (apparently HHS’ new verbiage for the Triple Aim).
“We are shifting the culture of how people think about health care investments,” Patrick Conway, deputy administrator for innovation and quality and chief medical officer at the Centers for Medicare & Medicaid Services, told a packed crowd during an address at HIMSS15. “We’re trying to use a number of levers to get there.”
Conway rattled off a kind of “Best of CMS” list to illustrate his point: Pioneer ACO, Medicare Shared Savings Program, patient-centered medical home, Hospital Engagement Network, and so on. He noted that in 2011, almost no Medicare payments were tied to alternative payment models. Now, about 20 percent of payments are, and the agency plans to grow that to 50 percent by 2018.
Conway, who also runs the Center for Medicare & Medicaid Innovation, detailed various tests taking place at the state and local level. Maryland, for instance, is experimenting with population-based payments. He suggested that within five years, roughly 80 percent of hospital payments in the state will be population-based.
However, Conway acknowledged that while the agency is pushing for value- and outcome-based reforms, the underpinnings of the regulatory system are still rooted in fee for service and that the agency needs to remove some of the “undue” burdens that prevent providers from moving forward.
Integral to advancing value-based care — and the reason nearly 40,000 people are gathered here in Chicago this week — is health IT. Fielding questions from reporters, National Coordinator for Health Information Technology Karen DeSalvo, M.D., said that ONC is focused this year on spurring innovation, especially as it relates to interoperability. She announced a $1 million grant program that will reward 10 organizations that show promise in data exchange.
On that front, Jodi Daniel, director of the ONC Office of Policy, said during the press conference that so-called information blocking is a problem and is something the government needs to address. ONC last week issued a report to Congress alleging that some providers and vendors are “interfering with the exchange or use of electronic health information in ways that frustrate the goals of the HITECH Act and undermine broader health care reforms.”
Michael McCoy, M.D., ONC’s chief health information officer, details the findings in this video: