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March 25, 2015 12:00 AM

HHS enlists big healthcare names in payment reform bid

Virgil Dickson
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    Dignity Health, Rite Aid and Cigna are among healthcare players that have joined an HHS network convened to help the CMS tie 30% of Medicare payments to alternative payment models by the end of 2016.

    The group, called the Health Care Payment Learning and Action Network, will hold its first meeting Wednesday in Washington and is expected to set goals for alternative payment models by September.

    The network, announced in tandem with the goals in January, was conceived to accelerate the healthcare system's move away from fee-for-service pay. It will serve as a forum where payers, providers, employers, purchasers, states, consumer groups, individual consumers, and others can discuss, track, and share best practices on how to adopt models that emphasize value. More than 2,800 stakeholders have registered to participate, according to HHS.

    Also in January, some of the largest health systems and insurers in the nation announced the formation of a private task force with the goal of shifting 75% of their business to contracts with incentives for quality and lower-cost healthcare. Members of that group included Ascension, St. Louis, and Trinity Health, Livionia, Mich., and insurance giants Aetna and Health Care Service Corp. The task force members said they would reach their target by January 2020.

    Although healthcare providers, insurers, Medicare and state Medicaid programs have in some ways moved aggressively to test and deploy new payment models, some experts question the rigor of the most common alternative models, such as shared-savings accountable care arrangements that offer providers bonuses for meeting cost and quality targets but no consequences if they don't.

    “It is in our common interest to build a healthcare system that delivers better care, spends our health care dollars more wisely, and results in healthier people,” HHS Secretary Sylvia Burwell said in a statement Wednesday. “When government and business work together we can all benefit. Patients can get the right care at the right time, doctors can achieve the best ideals of their profession, and health care can be more affordable for individuals and companies.”

    Members of the new public-private group have also committed to work toward the goals on their own. For instance, Dignity Health has committed to move 50% of its payments to accountable care by 2018 and 75% by 2020. Cigna says it will have 90% of payments in value-based arrangements and 50% of payments in alternative payment models by 2018.

    The American College of Physicians, another member of the network, plans to promote and educate its physicians about alternative payment models, such as accountable care organizations and patient-centered medical homes.

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        • - Hospital of the Future (Fall)
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