There were two VERY big stories related to value-based payment models this week:
- HHS announced a goal to tie 50% of Medicare payments to “quality or value through alternative payment models” by the end of 2018 (!). According to the agency, roughly 20% of Medicare payments are currently through alternative payment models. Under “alternative payment models” – which include ACOs, bundled payment programs, and other initiatives – participating providers agree to assume some level of responsibility for both the quality and cost of care delivered. According to HHS’ press release, this is “the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.”
- Shortly after HHS’ announcement, a group providers and private payers announced the formation of the Health Care Transformation Task Force (HCTTF), and set a collective goal of putting “75% of their business into value-based arrangements” by 2020 (!). In an excellent interview with HealthLeaders Media, the head of the task force said he believes the transition to value-based models needs to be “rapid” because of the challenges (and confusion) associated with having to operate partly in a traditional fee-for-service approach and party in value-based programs. The HCTTF consists of 28 members, including some of the largest provider and payer organizations in the country.
Impact Advisors’ Thoughts: Either announcement on its own would be newsworthy. Collectively they are much bigger though, signaling commitment to value-based payment models from both the federal government and the private sector. The specific details of how current programs change as a result of the announcements – and how new programs that emerge are structured – will be interesting. For example, will more contracts require providers to assume tangible financial risk for their performance? How much will that level of risk increase over time as models continue to mature? Achieving the stated goals in the target timeframes may prove to be easier said than done, but the announcements still clearly underscore the fact that these changes are coming, and likely a lot sooner than many realize.
Anthem, which is one of the biggest health insurance companies in the country, was recently the victim of a cyberattack that could end up being “the largest breach of a healthcare company to date,” according to the New York Times. The database accessed by the hackers contained the personal information of as many as 80 million people, and included social security numbers, birthdates, and addresses.
Impact Advisors’ Thoughts: This wasn’t an unintentional breach or an unencrypted device that went missing; it was a deliberate cyberattack, just like the breach CHS was the victim of last summer. The news is an important reminder that hackers are increasingly targeting the industry as a whole, and any type of healthcare organization could a victim. For more information on how providers can overcome a false sense of security, make sure to download our white paper here.