Days after the Jan. 26 announcement by the U.S. Department of Human Services settings goals and a timeline for transitioning Medicare reimbursement from volume to value based, the Health Care Transformation Task Force (HCTTF) released nine principles that it says are “important components of successful accountable care payment arrangements and delivery models, and necessary to expanding ACOs [accountable care organizations] beyond their current footprint.”
The principles fall into three main categories and include:
Honoring Patient Choice and Improving Attribution
- Attribution models should support a patient’s ability to actively attest to their participation in a particular ACO as efforts to meet the Triple Aim — improving the patient’s experience of care and the health of populations served while reducing health care costs —are enhanced when an ACO works with an identifiable patient population.
Quality Measurement Improvement
- As ACOs pursue the Triple Aim, payers should create an environment where quality outcomes measurement can be used for more appropriate payment, consumer engagement, and public accountability.
- Establish an aligned approach to quality measurement across all three domains: measurement for payment, measurement for consumer engagement, and measurement for public accountability.
- Explore two statistically sound quality measurement approaches, establishing a system that rewards both improvement and achievement.
- Incentivize ACOs to contribute to emerging and innovative measures.
Improving Financial Stability
- Simply the financial model. Payers should offer to statistically sound financial models, designed so that all providers can participate.
- Allow ACOs to better facilitate prospectively attributed beneficiary receipt of care in appropriate settings, as they accept more financial risk and demonstrate high-quality care.
- Continuously improve access to complete, accurate, reliable, and timely data.
- Support transition to triple-aim programs.
Learn more about what’s in store for 2015 with the Pennsylvania Medical Society’s (PAMED) medical economics forecast, in which Dennis Olmstead, chief strategy officer and medical economist for PAMED, provides a look ahead with a forecast specifically tailored to assist physicians to strategically plan for this year and beyond.
“One of the biggest challenges will be controlling spending, even in the face of countervailing activity such as expensive new innovations, improved consumer confidence, and an aging society that requires more medical care and services,” said Mr. Olmstead during his 2015 forecast.
“The 800 pound gorilla in the room for 2015 will continue to be the Affordable Care Act. The stakes are high in 2015.”
PAMED is working on developing an educational series on the transition from volume to volume. Stay tuned to the Daily Dose, PAMED’s daily, all member email, for more information.