Have you heard that Health & Human Services (HHS) has set a goal of 50% of payments tied to quality / value by the end of 2018? If you have heard, well, are you ready? If the COPQ & patient outcomes weren't reasons enough to prepare for the coming changes in reimbursement, now you have this new impetus to improve as we go from volume to value. Amidst all this, consider this question: do you & your organization have a process to push out new (and more) quality endpoints as reimbursement changes? It's not just about prepping for the endpoints you do anticipate, but rather it is about having an organizational method to define, measure, analyze, improve, & control your systems related to the specifics of what comes next.
The Affordable Care Act created new models that shift the focus of payment from quantity to quality, which may be more successful than traditional capitation. Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell addressed the importance of setting value-based payment goals in a January 2015 New England Journal of Medicine article. The Secretary announced in 2015 a target of having 30 percent of Medicare payments tied to quality or value through alternative payment models by the end of 2016, and 50 percent of payments tied to quality or value by the end of 2018.