For the last half century, American healthcare has relied on a fee-for-service reimbursement system that rewards quantity of tests, procedures, and visits –not quality or outcomes. It’s no wonder that our health care has grown increasingly unaffordable.
But this is beginning to change, thanks to two decades of bipartisan leadership and most recently the overwhelming passage of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). By aligning federal policy with the most innovative private sector and state payment reform initiatives, the transition toward value-based care is succeeding, measurably improving healthcare quality and contributing to historically low per-person cost growth. Now is the time to put our foot on the gas to accelerate the shift toward value-based care and new models of delivery and provider payment. We recommend:
- Encouraging public and private investment in the testing and scaling of new alternative payment models as called for under MACRA
- Standing up more advanced models in Original Medicare that align with the private sector’s most aggressive efforts at reform, such as capitated or global payment
- Fix the Medicare Shared Savings Program by granting two-sided risk ACOs regulatory relief from certain site of service and telehealth restrictions