The Road From Volume To ValueReporting On Health Webinar

March 19, 2015

Jordan RauSenior Correspondent

Kaiser Health News202.654.1362

jrau@kff.org @jordanrau

•Piecemeal payment (per MD procedure, hospital visit)•No link to quality; more stuff done = more $$$• Same accountability as a criminal defense lawyer

Traditional Fee For

Service (FFS)

•Still paid per service but outcomes matter a bit•Bonus or penalties adjust the usual fee. Mandatory.•Examples: readmission rates, patient survey results, hospital infections. (All together about +2/- 6%)

Fee For Service Linked

To Quality

•A set fee per episode (e.g. bundled payment for knee surgery)•Gains or losses for overall cost of patients (ACOs)•Incentives for cross-provider cooperation..•Population-based payment . No link to volume (Maryland global payments)

Alternative Payment Models

Source: Centers for Medicare & Medicaid Services

The Road From Volume To ValueReporting On Health Webinar

March 19, 2015

Jordan RauSenior Correspondent

Kaiser Health News202.654.1362

jrau@kff.org @jordanrau

http://innovation.cms.gov/initiatives/map/index.html#model=

https://data.cms.gov/dataset/CMS-Innovation-Center-Model-Participants/x8pc-u7ta

http://www.vnews.com/news/dartmouth/13775559-95/efforts-to-cut-health-costs-limp-along

http://www.medicare.gov/physiciancompare/aco/search.html

Quality Data

https://data.cms.gov/ACO/Medicare-Shared-Savings-Program-Accountable-Care-O/yuq5-65xt

The Road From Volume To ValueReporting On Health Webinar

March 19, 2015

Jordan RauSenior Correspondent

Kaiser Health News202.654.1362

jrau@kff.org @jordanrau