CHICAGO-Medicare's goals to rapidly change how doctors and hospitals are paid by 2018 are welcome, but won't be easy to achieve, a CMS Innovation Center official said Wednesday.
“We are champions of bold goals,” Dennis Wagner, co-director of the CMS Innovation Center's Partnership for Patients and also its Transforming Clinical Practice Initiative, said during the American College of Healthcare Executives annual meeting in Chicago.
New targets call for Medicare to use accountable care or other new payment contracts for 30% of spending outside of managed care by 2016. That would increase to 50% by 2018.
Wagner called the 2016 target “pretty attainable” but the 2018 goal “a lift.”
More broadly, Medicare would require some incentive for quality or value to be tied to 85% of spending by 2016 and 90% by 2018 under the new targets.
The federal targets—and others in the private sector—would increase financial incentives for hospitals and doctors to improve quality and reduce cost. Policymakers hope the new incentives will reduce the amount doctors are paid based on the sheer volume of treatment they offer, which is cited for encouraging doctors to do more to be paid more.
Wagner said Innovation Center efforts are “aligning our work in every possible way” with January's announced targets.
The Innovation Center will soon announce the successful applicants of the Transforming Clinical Practice Initiative, an $840 million initiative designed to improve quality and reduce waste that is projected to involve 150,000 clinicians.
The effort and others are among the Innovation Center's growing and diverse project portfolio, which also includes Pioneer accountable care and the Partnership for Patients. Results from projects so far have been limited, the Innovation Center said in a recent report to Congress.
Dr. Paul McCann, the other co-director of the CMS Innovation Center's Partnership for Patients and the Transforming Clinical Practice Initiative, said that harm to patients at U.S. hospitals has dropped to 121 incidences of harm for every 1,000 patients from 145 incidences of harm per 1,000 patients in 2010, but it is difficult to identify how efforts contributed to that decline.
Two contractors have been hired to try to identify the role that Partnership for Patients may have played in the drop.
Partnership for Patients ended in December but the Innovation Center reopened the initiative to new applications, due at the end of the month, to continue the program.
Ascension Health, one of the nation's largest health systems, will apply for extending Partnership for Patients, said Ann Hendrich, chief quality, safety and nursing officer for Ascension, another conference presenter.
Hendrich said the Partnership greatly expanded the St. Louis-based system's access to good ideas because participants met virtually and during visits to share their experiences and what worked.
Participation could help Ascension Health adopt new models of care that will help the multistate system reach its own ambitious target for shifting payment into contracts with incentives for quality and lower-cost care, she said.
Ascension—along with Trinity Health, insurers Aetna and the Health Care Service Corp.—pledged in January to shift 75% of payment into accountable care or new payment models by 2020.
Hendrich called the goal “extremely” ambitious. Now, officials are working to develop a plan for how the system will achieve the goal. Ascension is not starting from scratch. It operates nine accountable care organizations. “We think setting the goal was the first right thing to do,” she said.
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