Robert King | May 12, 2022
The Biden administration is looking for ways to get more specialty providers into value-based care, including changing how payment models themselves are designed.
The Center for Medicare and Medicaid Innovation has outlined ways to get more safety-net and primary care providers involved, such as more generous savings and upfront investments. However, the center is still seeking input on specialty providers’ role in this effort.
“We are getting asked that question quite a bit,” said CMMI Director Liz Fowler during a session at the Health Care Payment Learning and Action Network virtual spring meeting. “Accountable care requires care delivery from primary and specialty care, and specialty is inextricably linked to our ability to deliver.”
Fowler said that the center is considering new models that focus on special populations that require more complex care.
The center therefore is thinking less of models that focus on chronic conditions and “more towards surgical bundles. [We] don’t anticipate models for every specialty,” Fowler said.
It remains unclear when these new models will roll out as CMMI is still gathering feedback, she added.
But the effort is part of a larger approach to get more providers into value-based care, especially as the goal of having every Medicare beneficiary in such a care relationship by 2030 looms.
Administration officials released a list of strategies late last month outlining how to increase participation.
Some of these reforms include re-evaluating the calculation of benchmarks for accountable care organizations, which represent the targets for savings and quality such organizations need to meet to qualify for shared savings.
CMMI also issued a strategy refresh last year that focused on how to better incorporate health equity into payment models.
Source: Fierce Healthcare