By Dawn Samaris, Kaufman, Hall & Associates, Inc.
The Centers for Medicare & Medicaid Services (CMS) is taking a carrot-and-stick approach in its efforts to decrease medical costs, reduce preventable hospital readmissions, and improve care quality through value-based care initiatives. These varied efforts include payment penalties for issues such as hospital-acquired infections, and alternative payment models that offer providers incentives to deliver efficient and effective care.
Sylvia Mathews Burwell, secretary of the U.S. Department of Health and Human Services, recently announced goals for Medicare payments over the next several years:
- 30 percent of payments will be made through alternative payment models such as accountable care organizations (ACOs) and bundled payments by the end of 2016, with the share expanding to 50 percent by the end of 2018
- 85 percent of fee-for-service payments will be tied to value-based or quality-incentive programs by the end of 2016, with the share expanding to 90 percent by the end of 2018