HHS gets to value-based reimbursement goal ahead of schedule

Barely a year after announcing its ambitious plan to tie reimbursement to quality of care, the U.S. Department of Health and Human Services announced March 3 that 30 percent of Medicare payments are now tied to alternative payment models, such as ACOs. The goal was reached nearly a year ahead of schedule, according to HHS, which states that more than 10 million Medicare patients are now getting higher-quality and more coordinated care. In January 2015, HHS set big goals to move 30 of Medicare to value-based arrangements by the end of 2016. “We reached this goal in partnership with the thousands of providers who collaborated with us in innovation,” said Patrick Conway, MD, deputy administrator for innovation quality and chief medical officer at CMS. There are 477 Medicare ACOs participating in the Shared Savings Program and the Pioneer ACO Model combined.  In 2014, these programs generated a total net savings of $411 million. ACOs represent about three quarters of progress toward the goal announced today, according to HHS, which says these gains will continue to increase over the course of the year, with the start of the Comprehensive Care for Joint Replacement model and the Oncology Care Model in 2016. As of January 2016, CMS estimates roughly $117 billion out of a projected $380 billion Medicare fee-for-service payments are tied to APMs.