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Healthcare payments tied to value-based care on the rise, now at 34 percent

In contrast, 41 percent of payments were based on volume rather than quality and efficiency, two hallmarks of value-based care.

Jeff Lagasse, Associate Editor

Value-based care is on the rise, and statistics are trickling in that detail to what extent this is true. Case in point is a new report from the Health Care Payment Learning and Action Network, a part of the U.S. Department of Health and Human Services.

The report's big finding: The percentage of healthcare payments tied to value-based care reached 34 percent in 2017, up 23 percent from 2015.

IMPACT

That total, 34 percent, came from two main categories of the refreshed alternative payment model framework -- APMs grafted onto a fee-for-service framework and population-based payment.

In contrast, 41 percent of payments were based on volume rather than quality and efficiency, two hallmarks of value-based care. The 34 percent of value-based payments encompasses roughly 226 million Americans, or 80 percent of the country's covered population.

Across markets, the amount of APMs for commercial business lines was 28.3 percent; for Medicare Advantage, 49.5 percent; for Medicare fee-for-service, 38.3 percent; and for Medicaid, 25 percent.

The report indicates that further progress in payment reform will lead to money flowing through more risk-based models.

THE TREND

The upswing in payments tied to APMs was detailed in a report from the Health Care Learning and Action Network nearly a year ago. Back then, looking at 2016 data, the organization found 29 percent of healthcare payments were tied to APMs, so the continued rise points to a natural progression.

In March, the Centers for Medicare and Medicaid Services announced changes that could help align quality reporting measures for physicians and hospitals as well as drive more eligible clinicians toward the advanced payment model track of MACRA.
 

Twitter: @JELagasse

Email the writer: jeff.lagasse@himssmedia.com

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