One of our favorite events of the year is the National Association of ACOs (NAACOS) Spring Conference because it draws a wide range of ACO leaders from around the country who are truly motivated to drive a positive change in healthcare. This year’s keynote address from the Administrator of CMS, Seema Verma, focused on the importance of transitioning the national healthcare system to a value-based care model. She talked about the complexities that value-based transformation entails as well as some of the successes they’ve seen so far.
Ms. Verma’s presentation came on the heels of CMS’s December 2018 “Pathways to Success” final rule on the Shared Savings Program, Medicare’s largest value-based purchasing program. In her remarks, she said that we must understand and address the drivers of healthcare spending and embrace transformation to a value-based system. ACOs are at the forefront of this transformation by advancing a new model of care delivery and providing better value to patients.
“Value-based care means upending the current paradigm, and in my view, it’s not happening fast enough,” she said. This means, in part, getting rid of unnecessary regulations and reducing overly burdensome requirements so providers can focus on patients and care coordination.
“Developing new coordinated care arrangements will require both flexibility in financial arrangements as well as the free and secure flow of healthcare information. Technology, and the sharing of data, underpin the entire move to innovative payment mechanisms. Without effective, open data sharing, providers cannot keep patients healthy. Without data to track patient progress or understand quality, payers cannot tie payment to outcome. This is why we are advancing interoperability and patient control of healthcare data as key enablers of value-based care.”
While adoption of Advanced APMs and taking on risk has been slow, she pointed to the difficulty providers have in obtaining data as one of the key challenges. “Providers in value-based models need to know in real time how their patients are doing and where they should be targeting their efforts.”
Engaging and empowering patients to choose high-value providers is another one of the barriers to value-based care. This will entail giving patients access to data and educating them to help make informed decisions and compare their options. And that, in turn, will create a competitive market where providers are incentivized to improve efficiency and attract patients.
Launching new payment models is the most significant work CMS is doing to move toward value-based care. The strong interest from eligible ACOs who have opted to participate in “Pathways to Success” is evidence of progress in the push to take on more risk. She pointed out that 38 percent of applicants for the “Pathways to Success” program have applied for Advanced APM status, compared with only 19 percent of ACOs enrolled in two-sided risk arrangements today.
There’s a lot of work ahead to clear the way for value-based care, but as Ms. Verma pointed out, ACOs are a critical partner in driving change. “You are leading the way to value-based care – you are the pioneers who are taking a risk and embarking on a new model of care delivery.”
We’ll be back at NAACOS in September! Mark your calendars for the NAACOS Fall Conference, coming to Washington, DC September 25 – 27.