Medicare innovation can spur the next round of payment reform

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Medicare innovation can spur the next round of payment reform (Stat)

Stat covers the transformation from fee-for-service to value-based care, and how many providers and organizations are looking to the Center for Medicare and Medicaid Innovation to lead efforts towards this change.

“With so much at stake, the actions of the Department of Health and Human Services are closely watched. The recent revisions in a set of mandatory payment reform pilots caused some to worry about continued HHS commitment to payment reform. Recently, CMS provided more visibility into their intentions by publishing a request for information based on a set of principles and new areas of emphasis in payment reform. The CMS information request makes two things clear. First, the current administration does intend to continue pursuing payment reform. Second, HHS leadership believes there is a way to go before we get it right.”

With this announcement, CMS has signaled a need to address participation and reporting challenges, but also “emphasizes greater patient and consumer involvement in reform efforts...Payment reform is needed to drive transparency, consumer empowerment, and competition in all areas of health care.” The article continues by addressing the need for risk adjustment to encourage competition, as well as more flexibility with administration, reporting (e.g. more consistent and meaningful performance measures) and regulations.

Stat also notes that CMS “could provide more support for state-led payment reform efforts that include public and private payers” and “accelerate progress by supporting clinicians and private payers in sharing insights about how health care providers can implement new approaches to delivering care.”

With a State Innovation Model grant from CMS, Delaware is already targeting many of these needs through five concentrated committees focused on value-based payment systems, practice transformation, the creation of a common scorecard for quality measurement, and engaging patients more in the medical process. Each committee is comprised of both public and private stakeholders from statewide governments, local health systems, community organizations, insurers, and area employers. For more information please visit us at

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