Physicians Weigh In on the Worth of Value-Based Payments

A majority of physician leaders plan to meet HHS goals of tying 30 percent of traditional Medicare payments to quality or value by the end of 2016, according to the results of an American Association for Physician Leadership poll. The poll was designed to evaluate how physicians are reacting to HHS’ announcement regarding guidelines for moving Medicare away from fee-for-service (FFS) reimbursement and towards value-based reimbursement.

Value-Based Payments

Value-based payments are being promoted by HHS as an alternative to FFS payments in order to reduce costs and improve health care delivery. The momentum towards value-based payments was enhanced by several sections of the Patient Protection and Affordable Care Act (ACA) (P.L.111-148). Specific value-based innovations initiated by the ACA include Section 3022 of the ACA, which mandated the establishment of a Medicare Shared Savings Program (MSSP); Section 3502, which supported the establishment of patient-centered medical homes (PCMHs); and the CMS Innovation Center, established by section 3021 of the ACA, which created the Bundled Payments for Care Improvement Initiative (BPCI).

Timeline

The specific timeline set out by HHS seeks to have 30 percent of all providers using alternative payment models that emphasize quality of service over quantity by 2016. CMS is hoping to achieve 50 percent participation in alternative payment models by 2018. The agency also wants 85 percent of a Medicare payment payments to be tied to qualify or value by 2016, increasing to 90 percent in 2018.

Results

The poll, which asked 656 physicians whether they were taking steps to meet the HHS value-based payment goals, revealed that 73 percent of those physicians were part of organizations which were striving to meet the HHS benchmarks. Another 15 percent of respondents indicated that they were not working towards those goals and 12 percent indicated that the goals did not apply to their particular type of organization. The poll also included comments from respondents regarding feelings on the push towards value-based payments. While some comments were receptive to the HHS move, others felt the initiative is too aggressive. For example, one physician leader wrote, “Yes, we’re taking steps, but we’re ‘light years’ away from being ready.” Another comment condemned the initiative saying, “This is another mandate with no clear path forward.”