Home Health & Hospice Week

Your outcomes will be more important than ever under new payment emphasis.

If you think ACOs and value-based purchasing are a passing fad you can ignore, think again. The Department of Health and Human Services has announced a new timeline aimed at converting Medicare spending to value-based payments rather than fee-for-service.

HHS has set “measurable goals and a timeline to move the Medicare program, and the health care system at large, toward paying providers based on the quality, rather than the quantity of care they give patients,” the agency says in a release.

Milestones: By the end of 2016, “HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements … and tying 50 percent of payments to these models by the end of 2018,” the agency says.

Plus: “HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs,” HHS says.

The Centers for Medicare & Medicaid Services already pays home health agencies and hospices under bundled payment systems, so they may not see big changes in that structure. But value-based purchasing, ACOs, and payment bundling across post-acute provider types will only pick up steam under this initiative, experts predict.

“It is in our common interest to build a health care system that delivers better care, spends health care dollars more wisely and results in healthier people,” HHS Secretary Sylvia Burwell says in the release. “Today’s announcement is about improving the quality of care we receive when we are sick, while at the same time spending our health care dollars more wisely.”

“HHS has already seen promising results on cost savings with alternative payment models, with combined total program savings of $417 million to Medicare due to existing ACO programs,” the agency notes. “HHS expects these models to continue the unprecedented slowdown in health care spending.”

Readmissions spotlight: “Initiatives like the Partnership for Patients, ACOs, Quality Improvement Organizations, and others have helped reduce hospital readmissions in Medicare by nearly eight percent — translating into 150,000 fewer readmissions between January 2012 and December 2013 — and quality improve-ments have resulted in saving 50,000 lives and $12 billion in health spending from 2010 to 2013,” HHS says.