Verma: Patient Care, Payment Design Need Value-Based Reforms

HealthPayerIntelligence (05/08/2018) Beaton, Thomas

Speaking at the American Hospital Association's (AHA) yearly meeting, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma said changes to patient care and payment design are needed to enhance value-based care reforms within the healthcare sector. Verma emphasized that CMS is dedicated to promoting quality-based reimbursement, consumer-directed healthcare decisions and cost transparency. As part of the agency's efforts to reduce regulatory and administrative burdens, a proposed rule seeks to reduce the quality measure reporting requirements for hospitals to receive Medicare reimbursements. This proposed rule also would increase payments to several types of inpatient Medicare facilities while removing outdated and redundant quality measurements. Verma said that price transparency is a critical component of successful value-based care organizations and could help catalyze value-based reforms. CMS will also reduce administrative burdens through the agency's "Patients Over Paperwork Initiative" that removes certain documentation requirements that may be redundant and limit a provider's productivity. CMS previously proposed that hospitals should be required to post health care service costs online. The agency also plans to equip patients with their own healthcare data to make better healthcare-related decisions. Verma pointed out that many upside risk accountable care organizations (ACOs) have not yet moved to a downside risk model, which could limit cost saving potential of CMS's ACOs.

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