Alternative payment models

Inadequate Data Hinders Federal Approach to Health Equity

Federal efforts to develop and improve payment models and other programs designed to foster health equity are often hamstrung by poor data: inconsistent data requests from program to program and flawed and incomplete data reporting by those participating in those programs. As a result, federal policymakers often are unable to tell whether programs – both those developed specifically to address health equity and those that are not – are having the desired effect on health equity. The result, according to a new study from the Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation, is that 1) [...]

iqtsupport2023-07-19T10:50:34-04:00July 19, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity|

Use of APMs, Value-Based Payments Continues to Increase

Payments based on alternative payment models and value-based measures continue to play a larger role in health care reimbursement. Almost 36 percent of health care payments involved APMs in 2018. In addition, fee for service accounted for 39 percent of payments. While these figures represent both represent increases over 2017, the rate at which they are growing has slowed. With APMs, one of the challenges is that providers have yet to come to terms with downside risk, which is required under some models. Medicare Advantage plans are especially advanced in adopting new approaches, with 53.6 percent of their payments tied [...]

iqtsupport2019-10-25T06:00:47-04:00October 25, 2019|Alternative payment models|

APM Use Rising

Alternative payment models now account for more than one-third of health care payments, according to a new analysis. Leading the way is Medicare Advantage plans, which expend nearly half of their Medicare payments through APMs. Learn more about this trend in health care delivery and payments in the report “APM Measurement: Progress of Alternative Payment Models,” which was prepared by the Health Care Payment Learning & Action Network and can be found here.

iqtsupport2018-10-26T06:00:53-04:00October 26, 2018|Alternative payment models|

Alternative Payment Model Spending Grows

In 2016, 29 percent of all health care payments were made through alternative payment models, continuing the movement toward paying for value rather than for volume. That 29 percent in 2016 was up from 23 percent in 2015. APMs include shared savings and shared risk programs, bundled payments, and population-based payments. Fee-for-service and other “legacy” payments accounted for 43 percent of health care payments in 2016 and pay for performance or care coordination fees accounted for another 28 percent of payments. These numbers come from a report from the Health Care Payment Learning and Action Network. Learn more about the [...]

iqtsupport2017-11-03T06:00:35-04:00November 3, 2017|Uncategorized|