BY
ROBERT KING | JANUARY 29, 2019
CMS Administrator Seema Verma on Tuesday said the agency is
exploring ways to apply its value-based payment models beyond Medicare and
encourage more providers to buy in to the programs.
Currently, only 14% of Medicare providers participate in
value-based arrangements, Verma said at the CMS Quality Conference in
Baltimore. But the agency hopes its new cadre of models will change that.
The CMS will develop templates that states can use to implement
similar pay models in their own programs, she said.
"Ideally, providers that are participating in models are
doing so not only for their Medicare patients but for all their payers,"
she said.
The Trump administration has been hinting at new models for months, but there is no timetable for their release. The new models will help providers only take on the risk they're comfortable with, Verma said.
"Not every provider is comfortable taking full risk, but we can still figure out ways to create incentives for providers to deliver outcomes of low cost and high quality," she said.
The new models will focus on different types of diseases such as end-stage renal disease, cancer and other serious illnesses.
Like the changes to the Medicare ACO program, Verma said these models will give providers additional flexibility.
Verma also hinted at changes to the disparity in payments between urban and rural healthcare providers, since 40% of rural hospitals have negative operating margins and their closures would significantly impact the communities they serve.
The CMS is thinking about changing the wage index formula that adjusts Medicare payments based on the labor costs a hospital faces in its area. Verma did not divulge what specific changes could occur to the wage-index formula.
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The Trump administration has been hinting at new models for months, but there is no timetable for their release. The new models will help providers only take on the risk they're comfortable with, Verma said.
"Not every provider is comfortable taking full risk, but we can still figure out ways to create incentives for providers to deliver outcomes of low cost and high quality," she said.
The new models will focus on different types of diseases such as end-stage renal disease, cancer and other serious illnesses.
Like the changes to the Medicare ACO program, Verma said these models will give providers additional flexibility.
Verma also hinted at changes to the disparity in payments between urban and rural healthcare providers, since 40% of rural hospitals have negative operating margins and their closures would significantly impact the communities they serve.
The CMS is thinking about changing the wage index formula that adjusts Medicare payments based on the labor costs a hospital faces in its area. Verma did not divulge what specific changes could occur to the wage-index formula.
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