A new alliance of health systems, insurers and other assorted organizations unveiled today aims to give health care a big shove toward becoming value and quality-driven, and goes a step further than HHS’ announcement earlier this week.
Similar to HHS, which set some specific goals for how much of Medicare’s reimbursement should be tied to value, the members of the newly formed Health Care Transformation Task Force set their own target of putting 75 percent of their business into value-based arrangements tied to the Triple Aim by 2020.
The task force founders hope to speed health care’s move away from fee-for-service reimbursement. “By joining together, we are well positioned to introduce more effective change, more quickly, with more impactful results,” said Fran Soistman, executive vice president of government services, Aetna, in a news release.
At least one interested party suggests that the goals are too ambitious. "We are really excited about the amount of experimentation that's happening with payment," said Suzanne Delbanco, executive director of the Catalyst for Payment Reform, an existing group of employers and purchasers. CPR endorses a goal of having 20 percent of payments be tied to value by 2020, in order to allow time to test the new models. "We're not yet in a position to know which alternative payment methods are going to pan out for us in terms of improving quality and reducing costs," Delbanco said. "This [new] coalition has set a goal for changing how we pay for care, our goal is to first change how we pay for care and then learn about what works and spread those methods," she said.
The task force also made a series of recommendations that seek to clarify how quality should be measured, reported and used, as well as setting some parameters for the financial models being utilized by ACOs.
The recommendations, which also will serve as the core of a comment letter regarding changes to Medicare’s Shared Savings Program, include a call for only outcome measures to be used in calculating clinical quality-based reimbursement.
Among the task force’s many measure-related suggestions is one that recommends that claims-based and patient-reported measures be combined with process measures to create an accurate picture of care for consumers to use.
The membership list includes large health care and insurer organizations such as Advocate Health Care, Dignity Health and Health Care Service Corp., as well as smaller companies such as PatientPing and Remedy Partners.
"It is encouraging to see so many players — from government to employers to healthcare companies — shifting the focus onto value," said Ceci Connolly, managing director of PricewaterhouseCooper’s Health Research Institute, in an email.