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CMS announces major shift in the way it will pay Medicare providers

CMS announces major shift in the way it will pay Medicare providers

This week, the U.S. HHS Centers for Medicare and Medicaid (CMS) services made a historic announcement about the way it will pay providers for Medicare services. In an article published in the New England Journal of Medicine, CMS said that by 2018, at least 90 percent of its payments will be tied to quality or value.

This represents a dramatic shift from the current, primarily fee-for-service reimbursement approach that is currently used for most Medicare claims. CMS’ ‘Better, Smarter, Healthier’ effort will focus on  three key areas: (1) improving the way providers are paid; (2) improving and innovating in care delivery; and (3) sharing information more broadly to providers, consumers, and others to support better decisions while maintaining privacy.

As MeHAF and Payment Reform grantees have learned through the Payment Reform initiative, changes in payment alone aren’t sufficient to move the health care system toward providing care that is more patient-centered, effective and efficient.  Innovations in delivery systems and sharing information are also critical to driving change. We have also learned that without the largest single payer in the country making fundamental changes, improvements are impossible. 

This announcement from CMS has promise to dramatically influence the delivery of health care in the future.

Read Obamacare 2.0: the White House's radical new plan to change how doctors get paid, Vox online, 1/28/2015.
 

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