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New Government Initiatives “A Shot in the Arm” for Value-Based Care

Medical practices will be able to deliver better value for patients covered by Medicare and Medicaid thanks, in part, to five new voluntary programs introduced by Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) in May.

Dr. Norman Chenven, ARC founding CEO and vice chairman of the Council of Accountable Physician Practices (CAPP), spoke with HealthLeaders about what these important changes will mean for practices and patients as they spread throughout the healthcare system in the coming years.

CMS – the Centers for Medicare & Medicaid Services  – projects that one program, the “Primary Cares Initiative,” could shift at least a quarter of people currently enrolled in traditional fee-for-service Medicare to a value-based model that rewards physicians for keeping patients healthy and out of the hospital.

What Exactly is Value-Based Care?

Value-based care ties payments for care to the quality of care provided and rewards providers for effectiveness as well as efficiency. Contrast this to the traditional fee-for-service model which pays providers retrospectively for services based on bill charges or annual fee schedules. Fee-for-service promotes quantity, where value-based care promotes quality by basing reimbursement on better care, improved population health, and reduced overall healthcare costs.

More Incentives for Value-Based Care

Dr. Chenven led an expert panel of health care executives at the 2019 World Health Care Congress to discuss the CMS Primary Cares Initiative and the future of accountable care organizations, healthcare practices that provide high-quality, coordinated care (the right care at the right time) to their Medicare patients.

"With this announcement for Medicare … there is a sense that this is going to be a shot in the arm and we're going to see some real new energy, innovation, and evolution of the value-based movement," Chenven told HealthLeaders. The article, “Medicare Just Invited More Competitors Into Value-Based Primary Care” takes a closer look at the new initiatives from CMS and how value-based care payment models in Medicare will influence the future of delivery models.

Making Healthcare Healthier

“The proposed new models are very important because they create additional pathways for primary care physicians to participate in accountable care and population health,” said Dr. Norman Chenven in a CAPP news release. “To transform our healthcare system to deliver better, more efficient care, we must change to a true value-based system – not only in payment, but in scalable clinical and operational methods as well. All players must be aligned in this seismic shift – including hospitals, primary care, and specialists.”

Read the full article in HealthLeaders.

Tags: Dr. Norman Chenven, Medicare, CSCA

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