The U.S. Department of Health and Human Services (HHS) has announced its intention to shift Medicare away from the current fee-for-service model and toward a system that pays providers based on the quality—rather than the quantity—of care they provide their patients. The announcement marks the first time in Medicare’s history that HHS has set explicit goals regarding alternative payment models and value-based payments.
HHS plans to tie 30% of fee-for-service Medicare payments to quality or value measures through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled-payment arrangements, by the end of 2016, and tie 50% of payments to these models by the end of 2018. Further, the agency’s plans include tying 85% of all traditional Medicare payments to quality or value by 2016, and 90% by 2018, through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs.
ASCO supports the HHS shift toward alternative payment models that encourage patient-centered, high-quality, high-value patient care, which aligns with ASCO’s own proposal to reform payment for oncology care, released in May 2014. Consolidated Payments for Oncology: Payment Reform to Support Patient-Centered Care for Cancer, a detailed proposal for a new approach to physician payment for cancer care services under Medicare, would fundamentally restructure the way oncologists are reimbursed for cancer care in the United States. The proposal aims to do so by focusing payment on the full range of patient services that oncologists provide while incentivizing high-quality, patient-centered care.
Developed by oncologists in community-based practices across the United States, the ASCO proposal also aims to improve the quality of cancer care by focusing on the value, rather than the volume, of services provided. ASCO will work closely with HHS as the agency implements its plan.
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