Providers tentatively welcome Medicare payment goals tied to quality

HHS Secretary Sylvia Burwell
HHS Secretary Sylvia Burwell

Long-term care leaders on Monday called a first-ever federal timeline for greater levels of bundled and other alternative payments “aggressive” but “a good thing.”

Health and Human Services Secretary Sylvia Mathews Burwell announced that 30% of traditional Medicare benefits should be paid through accountable care organizations, bundled payments or other alternative models by the end of next year. The level, now at 20%, should reach 50% within three years, she added.

The unprecedented announcement is expected to accelerate movement toward so-called value-based models and away from fee-for-service, or quantity-based, models.

A statement by American Health Care Association President and CEO Mark Parkinson expressed a willingness to work with stakeholders toward “the administration's aggressive goals” and also expressed hope they can be reached “without sacrificing access to high-quality skilled nursing care.”

“We have been in the process of finding smarter ways to inject greater accountability and savings into the Medicare payment structure,” he noted. “What we have today is in need of repair.

“We truly believe there can be some great outcomes on behalf of seniors on this,” added AHCA/NCAL Senior Vice President of Public Affairs Greg Crist. “The key now is consistency. We want a payment model that will let our members consistently track and know the care they're providing is being reimbursed at an effective level.”

Three years ago, Burwell recently wrote, Medicare made “almost no payments through these alternative payment models.” The new, alternative models “will depend on how well providers care for their patients, instead of how much care they provide,” Burwell said at a press conference Monday.

Long-term care providers will feel continued pressure to improve partnerships with hospitals. HHS also has decreed the latter should be receiving 90% of its Medicare payments based on value-based programs that emphasize hospital readmission reduction and other quality improvement within three years.